Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 33525 | AZ |
N | 207V00000X | Obstetrician & Gynecologist | A89473 | CA |
NPI | 1013013358 |
---|---|
Provider Name | Justice Huy Duc Tran |
First Address | Phoenix, AZ 85037-4403 |
Second Address | Avondale, AZ 85392-1003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2006 |
Last Update Date | 23/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
939481 | (05) | AZ |
I38555 | (02) |