Provider Demographics
NPI:1932573987
Name:LY, TRANG THAO (MBBS FRACP PHD)
Entity Type:Individual
Prefix:DR
First Name:TRANG
Middle Name:THAO
Last Name:LY
Suffix:
Gender:F
Credentials:MBBS FRACP PHD
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Mailing Address - Street 1:780 WELCH RD
Mailing Address - Street 2:MAIL CODE 5776
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-1516
Mailing Address - Country:US
Mailing Address - Phone:650-215-0732
Mailing Address - Fax:
Practice Address - Street 1:780 WELCH RD
Practice Address - Street 2:MAIL CODE 5776
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1516
Practice Address - Country:US
Practice Address - Phone:650-215-0732
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-13
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAF4102080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology