Provider Demographics
NPI:1902909393
Name:MARRAN, LYNN FRANCIS (OD)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:FRANCIS
Last Name:MARRAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:LYNN
Other - Middle Name:
Other - Last Name:MARRAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:17451 BASTANCHURY RD
Mailing Address - Street 2:104 CA
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-1857
Mailing Address - Country:US
Mailing Address - Phone:714-961-2020
Mailing Address - Fax:714-961-2020
Practice Address - Street 1:17451 BASTANCHURY RD
Practice Address - Street 2:104 CA
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92886-1857
Practice Address - Country:US
Practice Address - Phone:714-961-2020
Practice Address - Fax:714-961-2020
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11250TPA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U88832Medicare UPIN
CAWOP1125AMedicare ID - Type Unspecified