Individual
DR. MI LE TRAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
11110 N TATUM BLVD, SUITE 103, PHOENIX, AZ 85028-1607
(602) 443-0400
(602) 443-0401
Mailing address
11110 N TATUM BLVD, SUITE 103, PHOENIX, AZ 85028-1607
(602) 443-0400
(602) 443-0401
Taxonomy
Speciality
Code
Description
License number
State
2084P0015X
Psychosomatic Medicine Physician
Primary
22239
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22239 MD
STATE MEDICAL LICENSE
AZ
Enumeration date
01/02/2007
Last updated
07/08/2007
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