Provider Demographics
NPI:1639968639
Name:TRAN, TAY THI BELLA
Entity type:Individual
Prefix:
First Name:TAY THI
Middle Name:BELLA
Last Name:TRAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:BELLA
Other - Middle Name:
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:6442 ALEXANDRIA DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-2524
Mailing Address - Country:US
Mailing Address - Phone:714-312-8118
Mailing Address - Fax:
Practice Address - Street 1:8942 GARDEN GROVE BLVD STE 104
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92844-3332
Practice Address - Country:US
Practice Address - Phone:714-638-0852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35928152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist