MEDICARE: QUYNH TRAN OPTOMETRY, INC

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	152W00000X	Optometrist	12998	CA

General Provider Information

NPI Number	:	1104340330
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUYNH TRAN OPTOMETRY, INC

Provider Business Mailing Address
First Line	:	5250 PHILADELPHIA ST STE D
Second Line	:
City	:	CHINO
State	:	CA
Zip	:	91710-2483
Country	:	US
Telephone Number	:	909-628-1226
Fax Number	:

Provider Business Practice Location Address
First Line	:	5250 PHILADELPHIA ST STE D
Second Line	:
City	:	CHINO
State	:	CA
Zip	:	91710-2483
Country	:	US
Telephone Number	:	909-628-1226
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT,/OPTOMETRIST
Name	:	DR. QUYNH N TRAN
Credential	:	OD
Telephone Number	:	909-628-1226

Provider Enumeration Date	:	07/31/2017
Last Update Date	:	07/21/2022

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