Provider Demographics
NPI:1912294588
Name:TRAN, NGOC TUYEN THI (PA-C)
Entity type:Individual
Prefix:MISS
First Name:NGOC
Middle Name:TUYEN THI
Last Name:TRAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2712 AUGUSTINE DR STE 120
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95054-2941
Mailing Address - Country:US
Mailing Address - Phone:408-780-2542
Mailing Address - Fax:
Practice Address - Street 1:2712 AUGUSTINE DR STE 120
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95054-2941
Practice Address - Country:US
Practice Address - Phone:408-780-2542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-05
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52385363AM0700X
NC0010-02736363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical