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General NPI Number Information
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NPI Number | 1871302828
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Entity Type | Organization
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Legal Business Name | DR. AUSTIN TRAN, O.D., OPTOMETRIC CORP.
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Dates
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Enumeration Date | 01/04/2025
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Last Update Date | 01/04/2025
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Provider Practice Location Address
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Address Line | 9710 WINTER GARDENS BLVD STE LAKESIDE
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City | LAKESIDE
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State | CA
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Zip | 92040-3867
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Country | US
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Telephone | 619-443-1075
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Fax |
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Provider Business Mailing Address
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Address Line | 13322 RAMONA DR
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City | GARDEN GROVE
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State | CA
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Zip | 92843-2643
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Country | US
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Telephone | 512-739-0706
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Fax |
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Authorized Official
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Title or Position | OWNER/OPTOMETRIST
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Name | DR. AUSTIN TRAN
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Credential | OD
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Telephone | 512-739-0706
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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