Provider Demographics
NPI:1578614616
Name:TRAN, LILIAN LIEU (OD)
Entity Type:Individual
Prefix:
First Name:LILIAN
Middle Name:LIEU
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 1:457 LOS CERRITOS MALL # F15-16
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-5426
Mailing Address - Country:US
Mailing Address - Phone:562-809-8826
Mailing Address - Fax:562-809-4113
Practice Address - Street 1:3370 S BRISTOL ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-8203
Practice Address - Country:US
Practice Address - Phone:714-641-5950
Practice Address - Fax:714-641-5192
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10430TPA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWOP10430Medicare ID - Type Unspecified
CAU51709Medicare UPIN