Basic Information
Provider Information
NPI: 1730228750
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TRAN
FirstName: HOAN
MiddleName: PHAN
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
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OtherLastName:  
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OtherMiddleName:  
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OtherLastNameType:  
Mailing Information
Address1: 2211 LOMAS BLVD NE
Address2: MSC 084770
City: ALBUQUERQUE
State: NM
PostalCode: 871310001
CountryCode: US
TelephoneNumber: 5052723401
FaxNumber:  
Practice Location
Address1: UNM HOSPITAL NEUROLOGICAL SURGERY
Address2: 2211 LOMAS BLVD NE
City: ALBUQUERQUE
State: NM
PostalCode: 871310001
CountryCode: US
TelephoneNumber: 5052723401
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/06/2007
LastUpdateDate: 06/24/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207T00000X2004-0186NMY Allopathic & Osteopathic PhysiciansNeurological Surgery 

No ID Information.


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