Provider Demographics
NPI:1962036616
Name:TRAN, LANE N
Entity Type:Individual
Prefix:
First Name:LANE
Middle Name:N
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 1:15524 CARDAMON WAY
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92782-1910
Mailing Address - Country:US
Mailing Address - Phone:714-310-7199
Mailing Address - Fax:
Practice Address - Street 1:2472 CHAMBERS RD STE 120
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-6954
Practice Address - Country:US
Practice Address - Phone:714-310-7199
Practice Address - Fax:949-569-5396
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-02
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34788111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor