Phong Tran, MD
Student in an Organized Health Care Education/Training Program in Colton, CA. Individual provider (NPI-1).
NPI number1710568720
StatusActive
Last updated in NPPESDec 30, 2024
Details
- NPI
- 1710568720
- Entity type
- Individual (NPI-1)
- Name
- Phong Tran
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 20, 2021
- Certification date
- Apr 20, 2021
- Last updated
- Dec 30, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
400 N Pepper AveColton, CA 92324-1801
Phone 909-580-3366 · Fax 909-580-3332
Mailing address
400 N Pepper AveColton, CA 92324-1801
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