Individual
LONG KHAC TRAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
8731 W PICO BLVD, LOS ANGELES, CA 90035-2205
(310) 213-5437
Mailing address
25145 SOUTHPORT ST, LAGUNA HILLS, CA 92653-4922
(949) 295-3112
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
95012485
CA
Other
Enumeration date
08/17/2019
Last updated
05/11/2021
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