Provider Demographics
NPI:1366587933
Name:THANH QUOC TRAN, M.D. INC
Entity type:Organization
Organization Name:THANH QUOC TRAN, M.D. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THANH
Authorized Official - Middle Name:QUOC
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-441-4882
Mailing Address - Street 1:439 OFARRELL ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-2009
Mailing Address - Country:US
Mailing Address - Phone:415-441-4882
Mailing Address - Fax:
Practice Address - Street 1:320 13TH ST
Practice Address - Street 2:STE 109
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-3910
Practice Address - Country:US
Practice Address - Phone:510-268-8899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA52468207R00000X, 2084N0400X
CAA525468207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A524682Medicaid
CAZZZ30238ZMedicare ID - Type UnspecifiedPROVIDER NUMBER