MEDICARE: DR. TERI THUY NGOC TRAN D.C.

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	DC28437	CA

General Provider Information

NPI Number	:	1811002488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TERI THUY NGOC TRAN D.C.

Provider Business Mailing Address
First Line	:	25 N 14TH ST STE 630
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95112-6212
Country	:	US
Telephone Number	:	408-297-2225
Fax Number	:	408-297-2226

Provider Business Practice Location Address
First Line	:	25 N 14TH ST STE 630
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95112-6212
Country	:	US
Telephone Number	:	408-297-2225
Fax Number	:	408-297-2226

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

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	06/23/2008

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