Individual
JANIE KWAK-TRAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5052 S JONES BLVD STE 105, LAS VEGAS, NV 89118-0552
(702) 220-9611
(702) 220-9163
Mailing address
10624 S EASTERN AVE # A285, HENDERSON, NV 89052-2982
(702) 220-9611
(702) 220-9163
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
10236
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002018869
—
NV
01
—
10236
NV STATE LICENSE
NV
01
—
861057211
TRICARE
NV
Enumeration date
09/28/2006
Last updated
08/08/2013
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