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Kien Phuc Tran

Internal Medicine

Allopathic & Osteopathic Physicians

15491 Pasadena Ave Apt 87, Tustin, CA 92780-4247

PECOS Enrollment

This provider is enrolled in PECOS as KIEN TRAN.

Based on the most recent information from CMS, provider Kien Phuc Tran is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 11:47 AM.

Profile Details

Provider ID
1396831889
Provider Type
Individual
Full Name
Tran, Kien Phuc
Title
Dr.
Credential
MD

Gender
Male
Sole Proprietor
Yes
Enumeration Date
10/4/2006
Last Updated
7/8/2007

Contact Information

Practice Location

15491 Pasadena Ave Apt 87, Tustin, CA 92780-4247

(832) 287-6252

Unlisted Fax

Mailing Location

15491 Pasadena Ave Apt 87, Tustin, CA 92780-4247

(832) 287-6252

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207R00000X	Description Internal Medicine Allopathic & Osteopathic Physicians	License A88769 California
Code 282N00000X	Description General Acute Care Hospital Hospitals	License A88769 California

Kien Phuc Tran

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

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