| Trach P. Dang M.d., Inc | |
|
2114 Senter Rd Ste 24 San Jose CA 95112-2608 | |
| (408) 293-2188 | |
| (408) 292-5367 |
| Full Name | Trach P. Dang M.d., Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2114 Senter Rd Ste 24, San Jose, California |
| Authorized Official Name and Position | Thanh Nguyet La (MEDICAL ASSISTANT) |
| Authorized Official Contact | 4088290655 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Trach P. Dang M.d., Inc 2114 Senter Rd Ste 24 San Jose CA 95112-2608 Ph: (408) 293-2188 | Trach P. Dang M.d., Inc 2114 Senter Rd Ste 24 San Jose CA 95112-2608 Ph: (408) 293-2188 |
| NPI Number | 1104481340 |
|---|---|
| Provider Enumeration Date | 05/02/2019 |
| Last Update Date | 05/02/2019 |
| Medicare PECOS PAC ID | 9830084409 |
|---|---|
| Medicare Enrollment ID | O20040220001093 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104481340 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Trach Dang |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215959796 PECOS PAC ID: 7618863671 Enrollment ID: I20040302001293 |
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