Provider Demographics
NPI:1447848247
Name:TRAN, PHA (PA)
Entity type:Individual
Prefix:
First Name:PHA
Middle Name:
Last Name:TRAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:11161 WOODBURY RD
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-3533
Mailing Address - Country:US
Mailing Address - Phone:408-646-3190
Mailing Address - Fax:
Practice Address - Street 1:11161 WOODBURY RD
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-3533
Practice Address - Country:US
Practice Address - Phone:408-646-3190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-06
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical