Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | G81800 | CA |
Y | 2081P2900X | Pain Medicine | G81800 | CA |
NPI | 1063407302 |
---|---|
Provider Name | Dr. Sherman Nam Tran |
First Address | Campbell, CA 95008-1948 |
Second Address | Campbell, CA 95008-1948 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2005 |
Last Update Date | 11/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G42637 | (02) | CA |