Healthcare Provider Details

I. General information

NPI: 1942322011
Provider Name (Legal Business Name): TRANG VAN DAO O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 08/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8018 E SANTA ANA CANYON RD SUTIE 102
ANAHEIM CA
92808-1102
US

IV. Provider business mailing address

8018 E SANTA ANA CANYON RD SUITE 102
ANAHEIM CA
92808-1102
US

V. Phone/Fax

Practice location:
  • Phone: 714-282-9797
  • Fax: 714-282-9798
Mailing address:
  • Phone: 714-282-9797
  • Fax: 714-282-9798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number11049T
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: