Basic Information
| Provider Information | |||||||||
| NPI: | 1568801033 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TRAN | ||||||||
| FirstName: | QUANG | ||||||||
| MiddleName: | DUY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 80005 | ||||||||
| Address2: | |||||||||
| City: | CITY OF INDUSTRY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917168005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8008632002 | ||||||||
| FaxNumber: | 7707016811 | ||||||||
| Practice Location | |||||||||
| Address1: | 3865 JACKSON ST | ||||||||
| Address2: | |||||||||
| City: | RIVERSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9516882211 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2013 | ||||||||
| LastUpdateDate: | 05/14/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 13862 | CA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.