Provider Demographics
NPI:1053530147
Name:TRAN, HUGUES (PA-C)
Entity type:Individual
Prefix:
First Name:HUGUES
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 E HOLT BLVD
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91761-1618
Mailing Address - Country:US
Mailing Address - Phone:909-467-1605
Mailing Address - Fax:909-467-1608
Practice Address - Street 1:23900 IRONWOOD AVE
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92557-7151
Practice Address - Country:US
Practice Address - Phone:951-485-2570
Practice Address - Fax:951-485-2070
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA13434208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice