1013653773 NPI number — DR. NGOC-VAN THI TRAN-VALENCIA MD

Table of content: DR. NGOC-VAN THI TRAN-VALENCIA MD (NPI 1013653773)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013653773 NPI number — DR. NGOC-VAN THI TRAN-VALENCIA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TRAN-VALENCIA
Provider First Name:
NGOC-VAN
Provider Middle Name:
THI
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TRAN
Provider Other First Name:
NGOC-VAN
Provider Other Middle Name:
THI
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1013653773
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/30/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
DEPARTMENT OF PATHOLOGY AND LABORATORY MEDICINE
Provider Second Line Business Mailing Address:
4400 V STREET, SUITE 1107
Provider Business Mailing Address City Name:
SACRAMENTO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95817
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-734-0764
Provider Business Mailing Address Fax Number:
916-734-0299

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
DEPARTMENT OF PATHOLOGY AND LABORATORY MEDICINE
Provider Second Line Business Practice Location Address:
4400 V STREET, SUITE 1107
Provider Business Practice Location Address City Name:
SACRAMENTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95817
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-734-0764
Provider Business Practice Location Address Fax Number:
916-734-0299
Provider Enumeration Date:
05/06/2022

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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