Healthcare Provider Details

I. General information

NPI: 1356641054
Provider Name (Legal Business Name): DARLENE TRAN VAN D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DIEM-HA TRAN VAN D.C.

II. Dates (important events)

Enumeration Date: 10/27/2010
Last Update Date: 10/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2381 SENTER RD
SAN JOSE CA
95112-2610
US

IV. Provider business mailing address

415 GWINN CT
SAN JOSE CA
95111-1725
US

V. Phone/Fax

Practice location:
  • Phone: 408-623-3208
  • Fax:
Mailing address:
  • Phone: 408-623-3208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number31711
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: