Provider Demographics
NPI:1245940949
Name:MELINDA TRAN LLC
Entity type:Organization
Organization Name:MELINDA TRAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DAC, MAOM, LAC
Authorized Official - Phone:617-913-2802
Mailing Address - Street 1:291 QUINCY SHORE DR
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02171-1516
Mailing Address - Country:US
Mailing Address - Phone:617-913-2802
Mailing Address - Fax:
Practice Address - Street 1:661 E BROADWAY
Practice Address - Street 2:
Practice Address - City:SOUTH BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02127-1503
Practice Address - Country:US
Practice Address - Phone:617-913-2802
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-02
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty