Provider Demographics
NPI:1831825215
Name:PHAN TRAN, DANNY (PA-C)
Entity type:Individual
Prefix:MR
First Name:DANNY
Middle Name:
Last Name:PHAN TRAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6708 STINCHCOMB DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73132-3713
Mailing Address - Country:US
Mailing Address - Phone:405-474-4594
Mailing Address - Fax:
Practice Address - Street 1:535 NW 9TH SUITE 235
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73102-2228
Practice Address - Country:US
Practice Address - Phone:405-772-4367
Practice Address - Fax:405-772-4339
Is Sole Proprietor?:No
Enumeration Date:2022-07-27
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4832363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical