MEDICARE: NGOC HOAI 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	111N00000X	Chiropractor	DC24236	CA

General Provider Information

NPI Number	:	1699328807
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NGOC HOAI TRAN

Provider Business Mailing Address
First Line	:	18341 SHERMAN WAY STE 101
Second Line	:
City	:	RESEDA
State	:	CA
Zip	:	91335-4437
Country	:	US
Telephone Number	:	818-344-1089
Fax Number	:	818-344-2849

Provider Business Practice Location Address
First Line	:	18341 SHERMAN WAY STE 101
Second Line	:
City	:	RESEDA
State	:	CA
Zip	:	91335-4437
Country	:	US
Telephone Number	:	818-624-3122
Fax Number	:	818-344-2849

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

Provider Enumeration Date	:	07/17/2019
Last Update Date	:	07/17/2019

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Directions to “ NGOC HOAI TRAN ” Practice Location

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