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General NPI Number Information
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NPI Number | 1235575333
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Entity Type | Organization
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Legal Business Name | THANG DUC TRAN, MD
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Dates
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Enumeration Date | 05/15/2013
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Last Update Date | 02/06/2014
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Provider Practice Location Address
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Address Line | 1569 LEXANN AVE STE 114
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City | SAN JOSE
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State | CA
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Zip | 95121-1794
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Country | US
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Telephone | 408-223-8818
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Fax | 408-223-8884
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Provider Business Mailing Address
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Address Line | 3125 GREENFORD CT
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City | SAN JOSE
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State | CA
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Zip | 95148-3680
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Country | US
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Telephone | 408-531-9923
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Fax |
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Authorized Official
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Title or Position | NP
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Name | MRS. MY LINH THI NGUYEN
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Credential | FNP-BC
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Telephone | 408-223-8818
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 713906
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License Number State | CA
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