Provider Demographics
NPI:1619965670
Name:TRAN, DI DAC (MD)
Entity Type:Individual
Prefix:DR
First Name:DI
Middle Name:DAC
Last Name:TRAN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2395 MONTPELIER DR
Mailing Address - Street 2:UNIT 6
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1619
Mailing Address - Country:US
Mailing Address - Phone:408-272-9228
Mailing Address - Fax:408-272-0762
Practice Address - Street 1:2395 MONTPELIER DR
Practice Address - Street 2:UNIT 6
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1619
Practice Address - Country:US
Practice Address - Phone:408-272-9228
Practice Address - Fax:408-272-0762
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-12
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAA52125208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A521250OtherMEDI-CAL NUMBER