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General NPI Number Information
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NPI Number | 1407902471
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Entity Type | Organization
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Legal Business Name | TAM T TRAN
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 04/21/2011
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Provider Practice Location Address
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Address Line | 696 E SANTA CLARA ST SUITE 104
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City | SAN JOSE
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State | CA
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Zip | 95112-1911
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Country | US
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Telephone | 408-993-0382
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Fax | 408-995-6470
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Provider Business Mailing Address
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Address Line | 696 E SANTA CLARA ST SUITE 104
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City | SAN JOSE
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State | CA
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Zip | 95112-1911
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Country | US
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Telephone | 408-993-0382
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Fax | 408-995-6470
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Authorized Official
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Title or Position | OWNER
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Name | TAM T TRAN
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Credential | C.O.
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Telephone | 408-993-0382
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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