Provider Demographics
NPI:1811002488
Name:TRAN, TERI THUY NGOC (DC)
Entity Type:Individual
Prefix:DR
First Name:TERI THUY
Middle Name:NGOC
Last Name:TRAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 N 14TH ST STE 630
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-6212
Mailing Address - Country:US
Mailing Address - Phone:408-297-2225
Mailing Address - Fax:408-297-2226
Practice Address - Street 1:25 N 14TH ST STE 630
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-6212
Practice Address - Country:US
Practice Address - Phone:408-297-2225
Practice Address - Fax:408-297-2226
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28437111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAV07123Medicare UPIN
CADC0284370Medicare ID - Type Unspecified