Provider Demographics
NPI:1295966489
Name:TRAN, THU MICHELLE (NP)
Entity type:Individual
Prefix:
First Name:THU
Middle Name:MICHELLE
Last Name:TRAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:THU
Other - Middle Name:
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 MEDICAL PLAZA DRIVE, RM. 1618
Mailing Address - Street 2:GOTTSCHALK MEDICAL PLAZA
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92697
Mailing Address - Country:US
Mailing Address - Phone:949-824-8334
Mailing Address - Fax:
Practice Address - Street 1:C240 MEDICAL SCIENCE I
Practice Address - Street 2:UCI INFUSION CENTER
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92697
Practice Address - Country:US
Practice Address - Phone:949-824-8334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-05
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP18981363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily