MEDICARE: DR. TRANG HA OD

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	3802	FL
2	152W00000X	Optometrist	11998	CA

General Provider Information

NPI Number	:	1245438555
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TRANG HA OD

Provider Business Mailing Address
First Line	:	10250 SANTA MONICA BLVD STE 2550
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90067-6598
Country	:	US
Telephone Number	:	424-249-1957
Fax Number	:	323-406-9952

Provider Business Practice Location Address
First Line	:	10250 SANTA MONICA BLVD STE 2550
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90067-6598
Country	:	US
Telephone Number	:	424-249-1957
Fax Number	:	323-406-9952

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

Provider Enumeration Date	:	07/07/2007
Last Update Date	:	05/22/2023

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