Basic Information
Provider Information
NPI: 1346480175
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TRAN
FirstName: UYEN
MiddleName: PHUNG
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: UCLA DEPT OF ANESTHESIOLOGY 757 WESTOOD PLZ
Address2: SUITE 3304
City: LOS ANGELES
State: CA
PostalCode: 900950001
CountryCode: US
TelephoneNumber: 3102678655
FaxNumber: 3102673766
Practice Location
Address1: UCLA DEPT OF ANESTHESIOLOGY 757 WESTOOD PLZ
Address2: SUITE 3304
City: LOS ANGELES
State: CA
PostalCode: 900950001
CountryCode: US
TelephoneNumber: 3102678655
FaxNumber: 3102673766
Other Information
ProviderEnumerationDate: 03/06/2009
LastUpdateDate: 11/30/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XA106870CAY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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