Provider Demographics
NPI:1750504387
Name:TRAN, BRYAN H (MD)
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:H
Last Name:TRAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:27800 MEDICAL CENTER ROAD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6447
Mailing Address - Country:US
Mailing Address - Phone:949-347-6777
Mailing Address - Fax:949-347-6782
Practice Address - Street 1:27800 MEDICAL CENTER ROAD
Practice Address - Street 2:SUITE 230
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6447
Practice Address - Country:US
Practice Address - Phone:949-347-6777
Practice Address - Fax:949-347-6782
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA54928207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A549280Medicaid
CA00A549280Medicaid
CAWA54928DMedicare ID - Type Unspecified