MEDICARE: JOYCE TRANDEM 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	390200000X	Student in an Organized Health Care Education/Training Program
2	152W00000X	Optometrist	OPT-002471	AZ

General Provider Information

NPI Number	:	1942867965
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOYCE TRANDEM OD

Provider Business Mailing Address
First Line	:	5639 W TIERRA BUENA LN
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85306-2424
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2330 N 75TH AVE STE 101
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85035-1200
Country	:	US
Telephone Number	:	623-849-8726
Fax Number	:

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

Provider Enumeration Date	:	05/24/2019
Last Update Date	:	03/11/2026

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Directions to “ JOYCE TRANDEM OD” Practice Location

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