Provider Demographics
NPI:1972656668
Name:TRAN, AMY TRAM (OD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:TRAM
Last Name:TRAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1314 POLK ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-4614
Mailing Address - Country:US
Mailing Address - Phone:415-593-5348
Mailing Address - Fax:
Practice Address - Street 1:1314 POLK ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-4614
Practice Address - Country:US
Practice Address - Phone:415-593-5348
Practice Address - Fax:866-465-4929
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12659152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist