MEDICARE: THANG DUC TRAN MD

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	207R00000X	Internal Medicine Physician	CLG81642	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	:	1275514069
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THANG DUC TRAN MD

Provider Business Mailing Address
First Line	:	1569 LEXANN AVE
Second Line	:	SUITE 114
City	:	SAN JOSE
State	:	CA
Zip	:	95121-1794
Country	:	US
Telephone Number	:	408-223-8818
Fax Number	:	408-223-8884

Provider Business Practice Location Address
First Line	:	969 STORY RD UNIT 6060A
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95122-4601
Country	:	US
Telephone Number	:	408-223-8818
Fax Number	:	408-223-8884

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

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	04/02/2020

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Directions to “ THANG DUC TRAN MD” Practice Location

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