Provider Demographics
NPI:1679647408
Name:TRAN, VINCENT (DC)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 E MAIN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-4134
Mailing Address - Country:US
Mailing Address - Phone:626-289-9957
Mailing Address - Fax:626-289-9956
Practice Address - Street 1:940 E MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-4134
Practice Address - Country:US
Practice Address - Phone:626-289-9957
Practice Address - Fax:626-289-9956
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27553111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW15462Medicare ID - Type Unspecified
CAU88098Medicare UPIN