Individual
HAI T TRAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12611 HESPERIA RD, SUITE A, VICTORVILLE, CA 92395-7720
(760) 951-8714
(760) 951-7134
Mailing address
12611 HESPERIA RD, SUITE A, VICTORVILLE, CA 92395-7720
(760) 951-8714
(760) 951-7134
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G083905
CA
207ND0101X
MOHS-Micrographic Surgery Physician
G083905
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G839050
—
CA
01
—
G083905
STATE LICENSE
CA
Enumeration date
05/04/2006
Last updated
04/14/2010
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