| Doctor Name: | DR. DOMINIQUE QUANG TRAN |
| NPI Number: | 1275573149 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | A64861 |
| Business Practice Address: | 3102 E. Highland Avenue Medical Staff Office Patton, CA - 92369 |
| Business Phone Number: | 9094257679 |
| Business Fax Number: | 9094256635 |
| Mailing Address: | 3102 E. Highland Avenue, Medical Staff Office PATTON |
| State: | CA |
| Postal Code: | 92369 |
| Phone Number: | 9094257679 |
| Fax Number: | 9094256635 |
| NPI Enumeration Date: | 06/07/2006 |
| NPI Last Update Date: | 09/16/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | A64861 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |