Provider Demographics
NPI:1033519376
Name:TRAN, HOA (OD)
Entity Type:Individual
Prefix:
First Name:HOA
Middle Name:
Last Name:TRAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14400 BEAR VALLEY RD
Mailing Address - Street 2:SUITE 357
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92392-5470
Mailing Address - Country:US
Mailing Address - Phone:760-955-6714
Mailing Address - Fax:
Practice Address - Street 1:14400 BEAR VALLEY RD
Practice Address - Street 2:SUITE 357
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92392-5470
Practice Address - Country:US
Practice Address - Phone:760-955-6714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-22
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14895152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist