Provider Demographics
NPI:1760763346
Name:TUAN ANH TRAN, PC
Entity Type:Organization
Organization Name:TUAN ANH TRAN, PC
Other - Org Name:TUAN ANH TRAN, PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TUAN
Authorized Official - Middle Name:ANH
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO, DC
Authorized Official - Phone:408-263-6207
Mailing Address - Street 1:989 STORY RD UNIT 8072
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95122-4603
Mailing Address - Country:US
Mailing Address - Phone:408-263-6207
Mailing Address - Fax:408-263-6245
Practice Address - Street 1:989 STORY RD UNIT 8072
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95122-4603
Practice Address - Country:US
Practice Address - Phone:408-263-6207
Practice Address - Fax:408-263-6245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-08
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0258150Medicaid
CA11058739OtherCAQH PROVIDER ID
CA11058739OtherCAQH PROVIDER ID
CADC0258150Medicare PIN