MEDICARE: JULIE TRAN

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	208100000X	Physical Medicine & Rehabilitation Physician	PTA11154	CA

General Provider Information

NPI Number	:	1427679927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE TRAN

Provider Business Mailing Address
First Line	:	111 LAKE AVE
Second Line	:
City	:	PIEDMONT
State	:	CA
Zip	:	94611-4339
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 LAKE AVE
Second Line	:
City	:	PIEDMONT
State	:	CA
Zip	:	94611-4339
Country	:	US
Telephone Number	:	510-978-2627
Fax Number	:

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

Provider Enumeration Date	:	05/06/2020
Last Update Date	:	05/06/2020

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Directions to “ JULIE TRAN ” Practice Location

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