Provider Demographics
NPI:1669216669
Name:WYNN MEDICAL CENTER RESEARCH AND EDUCATION INSTITUTE
Entity type:Organization
Organization Name:WYNN MEDICAL CENTER RESEARCH AND EDUCATION INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HUYNH
Authorized Official - Middle Name:W
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:616-990-0782
Mailing Address - Street 1:9120 VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-1920
Mailing Address - Country:US
Mailing Address - Phone:626-573-9003
Mailing Address - Fax:626-573-0641
Practice Address - Street 1:9120 VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-1920
Practice Address - Country:US
Practice Address - Phone:626-573-9003
Practice Address - Fax:626-573-0641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty