Provider Demographics
NPI:1447937552
Name:TRAN, WINNIE
Entity type:Individual
Prefix:
First Name:WINNIE
Middle Name:
Last Name:TRAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 W VALLEY BLVD UNIT C
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-3728
Mailing Address - Country:US
Mailing Address - Phone:626-208-6458
Mailing Address - Fax:
Practice Address - Street 1:415 W VALLEY BLVD UNIT C
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-3728
Practice Address - Country:US
Practice Address - Phone:626-943-9240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant