MEDICARE: DIANA 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	0618001343	VA

General Provider Information

NPI Number	:	1588729495
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIANA TRAN OD

Provider Business Mailing Address
First Line	:	PO BOX 42120
Second Line	:
City	:	FREDERICKSBURG
State	:	VA
Zip	:	22404-2120
Country	:	US
Telephone Number	:	540-300-2771
Fax Number	:	866-666-7044

Provider Business Practice Location Address
First Line	:	3102 PLANK RD STE 395
Second Line	:
City	:	FREDERICKSBURG
State	:	VA
Zip	:	22407-4900
Country	:	US
Telephone Number	:	540-786-2020
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DIANA TRAN
Credential	:	O.D.
Telephone Number	:	540-300-2771

Provider Enumeration Date	:	12/22/2006
Last Update Date	:	01/24/2024

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