MEDICARE: DR. HIEN LUU TRAN DC

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	111N00000X	Chiropractor	DC25526	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

General Provider Information

NPI Number	:	1184702714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HIEN LUU TRAN DC

Provider Business Mailing Address
First Line	:	6480 WEATHERS PL
Second Line	:	SUITE 225
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-3910
Country	:	US
Telephone Number	:	858-646-0616
Fax Number	:	858-646-0617

Provider Business Practice Location Address
First Line	:	6480 WEATHERS PL
Second Line	:	SUITE 225
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-3910
Country	:	US
Telephone Number	:	858-646-0616
Fax Number	:	858-646-0617

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	11/16/2008

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Directions to “ DR. HIEN LUU TRAN DC” Practice Location

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