Provider Demographics
NPI:1457856387
Name:TRANI, MARVIN CANLAS (DO)
Entity Type:Individual
Prefix:
First Name:MARVIN
Middle Name:CANLAS
Last Name:TRANI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15955 PARAMOUNT BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:PARAMOUNT
Mailing Address - State:CA
Mailing Address - Zip Code:90723-5144
Mailing Address - Country:US
Mailing Address - Phone:562-531-9806
Mailing Address - Fax:
Practice Address - Street 1:15955 PARAMOUNT BLVD STE A
Practice Address - Street 2:
Practice Address - City:PARAMOUNT
Practice Address - State:CA
Practice Address - Zip Code:90723-5144
Practice Address - Country:US
Practice Address - Phone:562-531-9806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-23
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA20A17835207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program