Basic Information
| Provider Information | |||||||||
| NPI: | 1295992576 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TRAN | ||||||||
| FirstName: | MINHNGA | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 481 SANDIA LOOP | ||||||||
| Address2: | |||||||||
| City: | BERNALILLO | ||||||||
| State: | NM | ||||||||
| PostalCode: | 870047076 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5058674696 | ||||||||
| FaxNumber: | 5057715107 | ||||||||
| Practice Location | |||||||||
| Address1: | 801 ENCINO PL NE | ||||||||
| Address2: | STE C-1 | ||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871022612 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052721475 | ||||||||
| FaxNumber: | 5052722360 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/22/2008 | ||||||||
| LastUpdateDate: | 06/09/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/09/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | A-1604-11 | NM | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.