Provider Demographics
NPI:1770821472
Name:TRAN, BEN VAN
Entity Type:Individual
Prefix:
First Name:BEN
Middle Name:VAN
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 1:2625 ZANKER RD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95134-2130
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:645 WOOL CREEK DR
Practice Address - Street 2:SUITE 97
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-2617
Practice Address - Country:US
Practice Address - Phone:408-283-6151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-30
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator