Provider Demographics
NPI:1295799534
Name:TRAN, KINH TU (MD)
Entity type:Individual
Prefix:DR
First Name:KINH
Middle Name:TU
Last Name:TRAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:15975 HARBOR BLVD
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-1303
Mailing Address - Country:US
Mailing Address - Phone:714-546-6575
Mailing Address - Fax:714-546-6573
Practice Address - Street 1:15975 HARBOR BLVD
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-1303
Practice Address - Country:US
Practice Address - Phone:714-546-6575
Practice Address - Fax:714-551-9411
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-13
Last Update Date:2015-01-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA52706207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA52706AMedicare ID - Type Unspecified
CAF95365Medicare UPIN