MEDICARE: MR. LIEN A 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	332B00000X	Durable Medical Equipment & Medical Supplies	46255	CA

General Provider Information

NPI Number	:	1699831339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LIEN A TRAN

Provider Business Mailing Address
First Line	:	1788 SIERRA LEONE AVE #107
Second Line	:
City	:	ROWLAND HTS
State	:	CA
Zip	:	91748
Country	:	US
Telephone Number	:	626-839-5159
Fax Number	:	626-839-5169

Provider Business Practice Location Address
First Line	:	1788 SIERRA LEONE AVE #107
Second Line	:
City	:	ROWLAND HTS
State	:	CA
Zip	:	91748
Country	:	US
Telephone Number	:	626-839-5159
Fax Number	:	626-839-5169

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

Provider Enumeration Date	:	12/28/2006
Last Update Date	:	07/08/2007

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