MEDICARE: DR. CHARLES C TRAN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	37943	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023175890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES C TRAN DDS

Provider Business Mailing Address
First Line	:	6175 STOCKTON BLVD
Second Line	:	SUITE 260
City	:	SACRAMENTO
State	:	CA
Zip	:	95824-4523
Country	:	US
Telephone Number	:	916-427-6263
Fax Number	:	916-427-4843

Provider Business Practice Location Address
First Line	:	6930 65TH ST
Second Line	:	SUITE 107B
City	:	SACRAMENTO
State	:	CA
Zip	:	95823-2343
Country	:	US
Telephone Number	:	916-427-6263
Fax Number	:	916-427-4843

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/02/2007
Last Update Date	:	02/07/2017

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