Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 07001235A | IN |
Y | 222Z00000X | Podiatrist | 07001235A | IN |
N | 213EP1101X | Primary Podiatric Medicine | PO 3787 | FL |
NPI | 1407213903 |
---|---|
Provider Name | An Quoc Tran |
First Address | Hollywood, FL 33021-1642 |
Second Address | Carmel, IN 46032-3019 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2016 |
Last Update Date | 08/06/2016 |