Provider Demographics
NPI:1841457322
Name:TRAN, TIEN
Entity type:Organization
Organization Name:TRAN, TIEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.T TECH
Authorized Official - Prefix:
Authorized Official - First Name:TIEN
Authorized Official - Middle Name:GIA
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-417-6979
Mailing Address - Street 1:7672 JADE COAST RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-3552
Mailing Address - Country:US
Mailing Address - Phone:619-417-6979
Mailing Address - Fax:
Practice Address - Street 1:7672 JADE COAST RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126
Practice Address - Country:US
Practice Address - Phone:619-417-6979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PLAYCO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital