Provider Demographics
NPI:1053513564
Name:TRAN, SCOTT CHUNG (DC)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:CHUNG
Last Name:TRAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 WASHINGTON AVE.
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147
Mailing Address - Country:US
Mailing Address - Phone:215-551-6838
Mailing Address - Fax:215-551-6718
Practice Address - Street 1:500 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-4028
Practice Address - Country:US
Practice Address - Phone:215-551-6838
Practice Address - Fax:215-551-6718
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC008844111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor