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General NPI Number Information
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NPI Number | 1437218864
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Entity Type | Organization
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Legal Business Name | THAO TRAN, O.D., INC
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 02/09/2024
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Provider Practice Location Address
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Address Line | 110 CIVIC CENTER DR STE 204
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City | VISTA
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State | CA
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Zip | 92084-6038
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Country | US
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Telephone | 760-753-3665
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Fax |
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Provider Business Mailing Address
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Address Line | 110 CIVIC CENTER DR STE 204
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City | VISTA
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State | CA
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Zip | 92084-6038
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Country | US
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Telephone | 760-753-3665
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Fax | 408-969-1653
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Authorized Official
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Title or Position | PRESIDENT
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Name | THAO TRAN
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Credential | O.D.
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Telephone | 760-753-3665
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WL0500X
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Taxonomy Name | Low Vision Rehabilitation Optometrist
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License Number | 12867
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License Number State | CA
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