Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 24144 | NE |
NPI | 1023131356 |
---|---|
Provider Name | Dr. Son Tran |
First Address | Lincoln, NE 68510-2468 |
Second Address | Lincoln, NE 68510-2468 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2007 |
Last Update Date | 20/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
118562 | SFGH INTERNAL USE ONLY-COMMERCIAL NUMBER (01) | |
RES000 | (02) |