MEDICARE: CHARLES C. TRAN, 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	122300000X	Dentist	37943	CA

General Provider Information

NPI Number	:	1316168768
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHARLES C. TRAN, DDS

Provider Business Mailing Address
First Line	:	6930 65TH ST
Second Line	:	SUITE 107B
City	:	SACRAMENTO
State	:	CA
Zip	:	95823-2343
Country	:	US
Telephone Number	:	916-422-5697
Fax Number	:	916-422-5612

Provider Business Practice Location Address
First Line	:	6930 65TH ST
Second Line	:	SUITE 107B
City	:	SACRAMENTO
State	:	CA
Zip	:	95823-2343
Country	:	US
Telephone Number	:	916-422-5697
Fax Number	:	916-422-5612

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. CHARLES C TRAN
Credential	:	D.D.S.
Telephone Number	:	916-422-5697

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	08/22/2020

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