Provider Demographics
NPI:1164278065
Name:THANH LE TRAN OD INC.
Entity type:Organization
Organization Name:THANH LE TRAN OD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THANH
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:916-265-9609
Mailing Address - Street 1:3881 E COMMERCE WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-4017
Mailing Address - Country:US
Mailing Address - Phone:916-265-9609
Mailing Address - Fax:916-265-9610
Practice Address - Street 1:3881 E COMMERCE WAY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-4017
Practice Address - Country:US
Practice Address - Phone:916-265-9609
Practice Address - Fax:916-265-9610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty