Provider Demographics
NPI:1902342611
Name:TRAN TA INC
Entity Type:Organization
Organization Name:TRAN TA INC
Other - Org Name:NEW OPTIX OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:858-729-8545
Mailing Address - Street 1:4898 CONVOY ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-1633
Mailing Address - Country:US
Mailing Address - Phone:858-565-1001
Mailing Address - Fax:858-565-1004
Practice Address - Street 1:4898 CONVOY ST
Practice Address - Street 2:SUITE 103
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-1633
Practice Address - Country:US
Practice Address - Phone:858-565-1001
Practice Address - Fax:858-565-1004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-18
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14530152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty