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Organization
ST. PAUL MEDICAL CLINIC A PROFESSIONAL CORPORATION
Active
Organization
ST. PAUL MEDICAL CLINIC A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANHTUAN DANG TRAN M.D. (PRESIDENT)
(818) 989-2406
Entity
Organization
Contact information
Practice address
15216 VANOWEN ST STE 2A, VAN NUYS, CA 91405-3679
(818) 989-2406
(818) 989-0696
Mailing address
15216 VANOWEN ST STE 2A, VAN NUYS, CA 91405-3679
(818) 989-2406
(818) 989-0696
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A90428
CA
261QM2500X
Medical Specialty Clinic/Center
A90428
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A904280
—
CA
Enumeration date
11/18/2006
Last updated
07/01/2019
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