Provider Demographics
NPI:1053974147
Name:TRINH, CHRISTINE THUY TRANG (DO)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:THUY TRANG
Last Name:TRINH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:641 MONTICELLO TER
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-5400
Mailing Address - Country:US
Mailing Address - Phone:408-206-8414
Mailing Address - Fax:
Practice Address - Street 1:227 N JACKSON AVE STE 235
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1635
Practice Address - Country:US
Practice Address - Phone:408-254-9192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-15
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101026336207Q00000X
CA20A19918207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine