MEDICARE: THANH QUOC TRAN, M.D. INC.

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	207R00000X	Internal Medicine Physician	A52468	CA
2	2084N0400X	Neurology Physician	A52468	CA
3	207Q00000X	Family Medicine Physician	A52468	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619012184
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THANH QUOC TRAN, M.D. INC.

Provider Business Mailing Address
First Line	:	439 OFARRELL ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94102-2009
Country	:	US
Telephone Number	:	415-441-4882
Fax Number	:

Provider Business Practice Location Address
First Line	:	2448 STORY RD
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95122-1029
Country	:	US
Telephone Number	:	408-729-1282
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. THANH QUOC TRAN
Credential	:	MD
Telephone Number	:	415-441-4882

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	07/26/2007

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