Individual
KIM D TRAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4102 PINION DR, USAF ACADEMY, CO 80840-2502
(719) 333-5792
Mailing address
PO BOX 204, USAF ACADEMY, CO 80840-0204
(949) 331-3065
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
00000000
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000000
I DONT HAVE AN ISSUER NUMBER
—
Enumeration date
08/21/2018
Last updated
08/21/2018
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