Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 62905 | CA |
NPI | 1033490073 |
---|---|
Provider Name | Dr. Jamie H Tran |
First Address | Rancho Santa Margarita, CA 92688-2176 |
Second Address | Rancho Santa Margarita, CA 92688-2176 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2011 |
Last Update Date | 30/07/2019 |