Provider Demographics
NPI:1770912214
Name:TRAN, ANH HOANG (LAC, MTCM)
Entity type:Individual
Prefix:MS
First Name:ANH
Middle Name:HOANG
Last Name:TRAN
Suffix:
Gender:F
Credentials:LAC, MTCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2930 W CANYON AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-4650
Mailing Address - Country:US
Mailing Address - Phone:858-531-5597
Mailing Address - Fax:
Practice Address - Street 1:2930 W CANYON AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4650
Practice Address - Country:US
Practice Address - Phone:858-531-5597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15647171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist