Provider Demographics
NPI:1609453604
Name:TRAN, VY CAO
Entity Type:Individual
Prefix:
First Name:VY
Middle Name:CAO
Last Name:TRAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 SMITHWOOD ST
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-4125
Mailing Address - Country:US
Mailing Address - Phone:714-660-8003
Mailing Address - Fax:
Practice Address - Street 1:184 SMITHWOOD ST
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-4125
Practice Address - Country:US
Practice Address - Phone:714-660-8003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-25
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA94518151D06346Medicaid