Healthcare Provider Details

I. General information

NPI: 1619012184
Provider Name (Legal Business Name): THANH QUOC TRAN, M.D. INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 07/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2448 STORY RD
SAN JOSE CA
95122-1029
US

IV. Provider business mailing address

439 OFARRELL ST
SAN FRANCISCO CA
94102-2009
US

V. Phone/Fax

Practice location:
  • Phone: 408-729-1282
  • Fax:
Mailing address:
  • Phone: 415-441-4882
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA52468
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberA52468
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA52468
License Number StateCA

VIII. Authorized Official

Name: DR. THANH QUOC TRAN
Title or Position: OWNER
Credential: MD
Phone: 415-441-4882