Provider Demographics
NPI:1649330978
Name:TRAN, NHAN T (OD)
Entity type:Individual
Prefix:DR
First Name:NHAN
Middle Name:T
Last Name:TRAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 E TUDOR RD
Mailing Address - Street 2:STE 200
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-7370
Mailing Address - Country:US
Mailing Address - Phone:907-274-7825
Mailing Address - Fax:907-274-7826
Practice Address - Street 1:450 E TUDOR RD
Practice Address - Street 2:STE 200
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-7370
Practice Address - Country:US
Practice Address - Phone:907-274-7825
Practice Address - Fax:907-274-7826
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK206152W00000X
CA12096T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1577562Medicaid
AKK164169Medicare PIN
AKU78994Medicare UPIN