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General NPI Number Information
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NPI Number | 1508681404
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Entity Type | Organization
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Legal Business Name | VIVIAN TRAN DDS DENTAL CORPORATION
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Dates
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Enumeration Date | 11/18/2024
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 11340 W OLYMPIC BLVD STE 240
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City | LOS ANGELES
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State | CA
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Zip | 90064-1612
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Country | US
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Telephone | 310-575-8828
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Fax |
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Provider Business Mailing Address
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Address Line | 1826 BUTLER AVE APT 104
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City | LOS ANGELES
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State | CA
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Zip | 90025-5481
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Country | US
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Telephone | 213-674-0456
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. VIVIAN TRAN
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Credential | DDS
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Telephone | 213-674-0456
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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