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General NPI Number Information
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NPI Number | 1356522239
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Entity Type | Organization
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Legal Business Name | M. TRANDUC M.D., INC
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Dates
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Enumeration Date | 11/19/2007
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Last Update Date | 11/19/2007
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Provider Practice Location Address
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Address Line | 455 OCONNOR DR SUITE 370
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City | SAN JOSE
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State | CA
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Zip | 95128-1633
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Country | US
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Telephone | 408-288-9900
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Fax | 408-288-9904
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Provider Business Mailing Address
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Address Line | PO BOX 24981
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City | SAN JOSE
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State | CA
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Zip | 95154-4981
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Country | US
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Telephone | 408-288-9900
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Fax | 408-288-9904
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Authorized Official
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Title or Position | CEO
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Name | DR. MATTHEW TRANDUC
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Credential | M.D., PH.D.
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Telephone | 408-288-9900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A90429
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License Number State | CA
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