Provider Demographics
NPI:1750707634
Name:TRAN, NGHIA TRUNG (PA-C)
Entity type:Individual
Prefix:
First Name:NGHIA
Middle Name:TRUNG
Last Name:TRAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:JIMMY
Other - Middle Name:TRUNG
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:345 COURT ST STE 201
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-4329
Mailing Address - Country:US
Mailing Address - Phone:508-746-5300
Mailing Address - Fax:508-747-2001
Practice Address - Street 1:345 COURT ST STE 201
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-4329
Practice Address - Country:US
Practice Address - Phone:508-746-5300
Practice Address - Fax:508-747-2001
Is Sole Proprietor?:No
Enumeration Date:2014-03-14
Last Update Date:2025-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
1117313OtherNCCPA