Provider Demographics
NPI:1043638893
Name:TRAN, TRUNG NAM (MD)
Entity type:Individual
Prefix:
First Name:TRUNG
Middle Name:NAM
Last Name:TRAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 OCHSNER BLVD STE 470
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056-5282
Mailing Address - Country:US
Mailing Address - Phone:504-595-8262
Mailing Address - Fax:504-754-6487
Practice Address - Street 1:120 OCHSNER BLVD STE 470
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-5282
Practice Address - Country:US
Practice Address - Phone:504-595-8262
Practice Address - Fax:504-754-6487
Is Sole Proprietor?:No
Enumeration Date:2014-03-30
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA306013208M00000X, 207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program