Provider Demographics
NPI:1922208529
Name:NINH HUY TRAN, M.D., INC.
Entity Type:Organization
Organization Name:NINH HUY TRAN, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NINH
Authorized Official - Middle Name:HUY
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-596-1999
Mailing Address - Street 1:750 EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-3106
Mailing Address - Country:US
Mailing Address - Phone:650-596-1999
Mailing Address - Fax:650-596-1987
Practice Address - Street 1:750 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-3106
Practice Address - Country:US
Practice Address - Phone:650-596-1999
Practice Address - Fax:650-596-1987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-20
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA70342207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A703420Medicaid
CA00A703420Medicaid
CA6218940001Medicare NSC
CA00A703422Medicare PIN