Healthcare Provider Details

I. General information

NPI: 1831704147
Provider Name (Legal Business Name): TU-ANH TRAN VU OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2020
Last Update Date: 09/14/2020
Certification Date: 09/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 SERRAMONTE CTR
DALY CITY CA
94015-2345
US

IV. Provider business mailing address

2030 3RD ST APT 6
SAN FRANCISCO CA
94107-4315
US

V. Phone/Fax

Practice location:
  • Phone: 650-992-8404
  • Fax:
Mailing address:
  • Phone: 504-810-4523
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number34682
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: