Provider Demographics
NPI:1407902471
Name:TAM T TRAN
Entity Type:Organization
Organization Name:TAM T TRAN
Other - Org Name:MISSION MEDICAL EQUIPMENT SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAM
Authorized Official - Middle Name:T
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:CO
Authorized Official - Phone:408-993-0382
Mailing Address - Street 1:696 E SANTA CLARA ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-1911
Mailing Address - Country:US
Mailing Address - Phone:408-993-0382
Mailing Address - Fax:408-995-6470
Practice Address - Street 1:696 E SANTA CLARA ST
Practice Address - Street 2:SUITE 104
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-1911
Practice Address - Country:US
Practice Address - Phone:408-993-0382
Practice Address - Fax:408-995-6470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4614620001Medicare NSC