| |
989 Story Rd Unit 8072, San Jose, CA 95122-4603 | |
(408) 263-6207 | |
(408) 263-6245 |
Full Name | |
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Type | Facility |
Speciality | General Practice |
Location | 989 Story Rd Unit 8072, San Jose, California |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1760763346 | NPI | - | NPPES |
DC0258150 | Medicaid | CA | |
11058739 | Other | CA | CAQH PROVIDER ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | (* (Not Available)) | Secondary |
208D00000X | General Practice | (* (Not Available)) | Primary |
Provider Name | Tuan Anh Tran |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1366467102 PECOS PAC ID: 5294965299 Enrollment ID: I20140313000302 |
Mailing Address | Practice Location Address |
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989 Story Rd Unit 8072, San Jose, CA 95122-4603 Ph: (408) 263-6207 | 989 Story Rd Unit 8072, San Jose, CA 95122-4603 Ph: (408) 263-6207 |