Provider Demographics
NPI:1417158478
Name:TRAN, ANNIE MY (DC)
Entity Type:Individual
Prefix:DR
First Name:ANNIE
Middle Name:MY
Last Name:TRAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 W. ADAMS BLVD
Mailing Address - Street 2:304
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90007
Mailing Address - Country:US
Mailing Address - Phone:213-749-5610
Mailing Address - Fax:
Practice Address - Street 1:825 W ADAMS BLVD
Practice Address - Street 2:304
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90007-2565
Practice Address - Country:US
Practice Address - Phone:213-749-5610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30508111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor