Provider Demographics
NPI:1447677091
Name:TRAN, DUNG
Entity type:Individual
Prefix:
First Name:DUNG
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8745 AERO DR STE 330
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1763
Mailing Address - Country:US
Mailing Address - Phone:858-268-4933
Mailing Address - Fax:858-268-0244
Practice Address - Street 1:8745 AERO DR STE 330
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1763
Practice Address - Country:US
Practice Address - Phone:858-268-4933
Practice Address - Fax:858-268-0244
Is Sole Proprietor?:No
Enumeration Date:2014-03-20
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator