Provider Demographics
NPI:1982347696
Name:TRAN, TAM THANH (MD)
Entity Type:Individual
Prefix:DR
First Name:TAM
Middle Name:THANH
Last Name:TRAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:THANH TAM
Other - Middle Name:
Other - Last Name:NGUYEN TRAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:6655 S CIMARRON RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-2181
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6655 S CIMARRON RD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-2181
Practice Address - Country:US
Practice Address - Phone:702-765-4034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-19
Last Update Date:2022-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program