Provider Demographics
NPI:1740335199
Name:TRAN, DUC T (MD)
Entity type:Individual
Prefix:
First Name:DUC
Middle Name:T
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 1:4323 W RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4044
Mailing Address - Country:US
Mailing Address - Phone:818-556-3451
Mailing Address - Fax:
Practice Address - Street 1:4323 W RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4044
Practice Address - Country:US
Practice Address - Phone:818-556-3451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA55588207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA55588AMedicare ID - Type Unspecified
H30981Medicare UPIN
WA55588CMedicare ID - Type Unspecified
WA55588BMedicare ID - Type Unspecified
WA55588EMedicare ID - Type Unspecified
WA55588DMedicare ID - Type Unspecified