MEDICARE: QUAN HONG TRAN OD

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	152W00000X	Optometrist	18004284A	IN

General Provider Information

NPI Number	:	1215508874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	QUAN HONG TRAN OD

Provider Business Mailing Address
First Line	:	814 E 21ST ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-1879
Country	:	US
Telephone Number	:	260-255-0285
Fax Number	:

Provider Business Practice Location Address
First Line	:	9741 E WASHINGTON ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46229-3035
Country	:	US
Telephone Number	:	317-869-0308
Fax Number	:	317-869-0975

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

Provider Enumeration Date	:	07/06/2021
Last Update Date	:	07/06/2021

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Directions to “ QUAN HONG TRAN OD” Practice Location

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