Provider Demographics
NPI:1275514069
Name:TRAN, THANG DUC (MD)
Entity Type:Individual
Prefix:
First Name:THANG
Middle Name:DUC
Last Name:TRAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1569 LEXANN AVE
Mailing Address - Street 2:SUITE 114
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95121-1794
Mailing Address - Country:US
Mailing Address - Phone:408-223-8818
Mailing Address - Fax:408-223-8884
Practice Address - Street 1:969 STORY RD UNIT 6060A
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95122-4601
Practice Address - Country:US
Practice Address - Phone:408-223-8818
Practice Address - Fax:408-223-8884
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-08
Last Update Date:2020-04-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CACLG81642207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G816420Medicaid
CA00G816420Medicare PIN
CA00G816420Medicaid