Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FC0800X | Contact Lens | CL1625 | CA |
N | 156FX1800X | Optician | SL5527 | CA |
NPI | 1447374913 |
---|---|
Provider Name | Mrs. Giang Huong Tran |
First Address | Reseda, CA 91335-4152 |
Second Address | Reseda, CA 91335-4152 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1965 | MEDICAL EYE SERVICE (01) | CA |
DX0041810 | (05) | CA |
OP0969 | EYEMED (01) | CA |