Provider Demographics
NPI:1558379610
Name:TRAN, TAYLOR NGOC-TRAM (OD)
Entity Type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:NGOC-TRAM
Last Name:TRAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3588 SPRINGBROOK AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148-3129
Mailing Address - Country:US
Mailing Address - Phone:408-605-6310
Mailing Address - Fax:
Practice Address - Street 1:670 NORTHRIDGE SHOPPING CTR
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906-2014
Practice Address - Country:US
Practice Address - Phone:831-443-6090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13127152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist