MEDICARE: HOA TRAN 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	34822	CA

General Provider Information

NPI Number	:	1588233134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOA TRAN OD

Provider Business Mailing Address
First Line	:	554 E SAN BERNARDINO RD
Second Line	:
City	:	COVINA
State	:	CA
Zip	:	91723-1747
Country	:	US
Telephone Number	:	626-332-1888
Fax Number	:

Provider Business Practice Location Address
First Line	:	554 E SAN BERNARDINO RD STE 102
Second Line	:
City	:	COVINA
State	:	CA
Zip	:	91723-1748
Country	:	US
Telephone Number	:	310-349-7847
Fax Number	:

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

Provider Enumeration Date	:	06/18/2021
Last Update Date	:	06/23/2021

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Directions to “ HOA TRAN OD” Practice Location

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