Provider Demographics
NPI:1104833821
Name:TRAN, THUY THI (OD)
Entity Type:Individual
Prefix:DR
First Name:THUY
Middle Name:THI
Last Name:TRAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2500 MILVIA ST
Mailing Address - Street 2:#208
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94704
Mailing Address - Country:US
Mailing Address - Phone:510-548-6630
Mailing Address - Fax:510-548-9765
Practice Address - Street 1:2500 MILVIA ST
Practice Address - Street 2:#208
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704
Practice Address - Country:US
Practice Address - Phone:510-548-6630
Practice Address - Fax:510-548-9765
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASD0126631152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist