Healthcare Provider Details

I. General information

NPI: 1275190969
Provider Name (Legal Business Name): VIREN RANA DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2019
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 LONG BEACH BLVD STE 300
LONG BEACH CA
90807-2008
US

IV. Provider business mailing address

40 TEMPLE ST STE 1B
NEW HAVEN CT
06510-2715
US

V. Phone/Fax

Practice location:
  • Phone: 562-984-7024
  • Fax: 562-984-9477
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number20A24404
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number20A24404
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: