| Justin Duc Tien Tran Professional Corporation | |
|
1256 S Magnolia Ave Anaheim CA 92804-5116 | |
| (714) 821-0973 | |
| Not Available |
| Full Name | Justin Duc Tien Tran Professional Corporation |
|---|---|
| Speciality | Dentist |
| Location | 1256 S Magnolia Ave, Anaheim, California |
| Authorized Official Name and Position | Justin Tran (DENTIST) |
| Authorized Official Contact | 7148210973 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Justin Duc Tien Tran Professional Corporation 1256 S Magnolia Ave Anaheim CA 92804-5116 Ph: (714) 821-0973 | Justin Duc Tien Tran Professional Corporation 1256 S Magnolia Ave Anaheim CA 92804-5116 Ph: (714) 821-0973 |
| NPI Number | 1114319027 |
|---|---|
| Provider Enumeration Date | 03/02/2015 |
| Last Update Date | 09/16/2019 |
| Medicare PECOS PAC ID | 6406186584 |
|---|---|
| Medicare Enrollment ID | O20191003000333 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114319027 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 49686 (California) | Primary |
| Provider Name | Justin Tran |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1154499564 PECOS PAC ID: 7214267392 Enrollment ID: I20191003002277 |
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