MEDICARE: MARVIN CANLAS TRANI DO

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	390200000X	Student in an Organized Health Care Education/Training Program
2	207Q00000X	Family Medicine Physician	20A17835	CA

General Provider Information

NPI Number	:	1457856387
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARVIN CANLAS TRANI DO

Provider Business Mailing Address
First Line	:	15955 PARAMOUNT BLVD STE A
Second Line	:
City	:	PARAMOUNT
State	:	CA
Zip	:	90723-5144
Country	:	US
Telephone Number	:	562-531-9806
Fax Number	:

Provider Business Practice Location Address
First Line	:	15955 PARAMOUNT BLVD STE A
Second Line	:
City	:	PARAMOUNT
State	:	CA
Zip	:	90723-5144
Country	:	US
Telephone Number	:	562-531-9806
Fax Number	:

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

Provider Enumeration Date	:	03/23/2018
Last Update Date	:	07/29/2021

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Directions to “ MARVIN CANLAS TRANI DO” Practice Location

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