Provider Demographics
NPI:1679809263
Name:TRAN, THAI GIA DIEU (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:
First Name:THAI GIA
Middle Name:DIEU
Last Name:TRAN
Suffix:
Gender:
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:934 S EUCLID ST
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92802-1523
Mailing Address - Country:US
Mailing Address - Phone:714-254-0224
Mailing Address - Fax:714-254-0234
Practice Address - Street 1:934 S EUCLID ST
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92802-1523
Practice Address - Country:US
Practice Address - Phone:714-254-0224
Practice Address - Fax:714-254-0234
Is Sole Proprietor?:No
Enumeration Date:2009-11-02
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA20656363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant