Provider Demographics
NPI:1649319666
Name:TRAN, DONNY (MD)
Entity type:Individual
Prefix:
First Name:DONNY
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12240 MATTHEW PL
Mailing Address - Street 2:
Mailing Address - City:STANTON
Mailing Address - State:CA
Mailing Address - Zip Code:90680-3967
Mailing Address - Country:US
Mailing Address - Phone:510-759-4087
Mailing Address - Fax:
Practice Address - Street 1:7761 GARDEN GROVE BLVD
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92841-4200
Practice Address - Country:US
Practice Address - Phone:714-898-8888
Practice Address - Fax:714-901-7580
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2006-0357207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1649319666Medicaid