Provider Demographics
NPI:1124555172
Name:TRAN, MICHAEL NGOC (OD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:NGOC
Last Name:TRAN
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:1928 E CORTNEY WAY
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-5713
Mailing Address - Country:US
Mailing Address - Phone:714-603-5719
Mailing Address - Fax:
Practice Address - Street 1:946 MANHATTAN BEACH BLVD
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-5120
Practice Address - Country:US
Practice Address - Phone:310-545-4585
Practice Address - Fax:310-546-3240
Is Sole Proprietor?:No
Enumeration Date:2017-05-20
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA33896TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist