MEDICARE: MR. HENRY HOANH TRAN OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	2142	CA
2	225XF0002X	Feeding, Eating & Swallowing Occupational Therapist	2142	CA
3	225XH1200X	Hand Occupational Therapist	2142	CA

General Provider Information

NPI Number	:	1013306695
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. HENRY HOANH TRAN OTR/L

Provider Business Mailing Address
First Line	:	4711 AVENIDA DE LAS ESTRELL
Second Line	:
City	:	YORBA LINDA
State	:	CA
Zip	:	92886-3104
Country	:	US
Telephone Number	:	714-858-1289
Fax Number	:

Provider Business Practice Location Address
First Line	:	4711 AVENIDA DE LAS ESTELL
Second Line	:
City	:	YORBA LINDA
State	:	CA
Zip	:	92886
Country	:	US
Telephone Number	:	714-858-1289
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/20/2015
Last Update Date	:	01/20/2015

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