MEDICARE: DR. BRANDEE TRAN MA 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	108161	CA

General Provider Information

NPI Number	:	1114642063
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRANDEE TRAN MA DDS

Provider Business Mailing Address
First Line	:	1751 COLORADO BLVD # 347
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90041-1348
Country	:	US
Telephone Number	:	415-218-5486
Fax Number	:

Provider Business Practice Location Address
First Line	:	1751 COLORADO BLVD # 347
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90041-1348
Country	:	US
Telephone Number	:	415-218-5486
Fax Number	:

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

Provider Enumeration Date	:	10/04/2022
Last Update Date	:	06/12/2023

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