Provider Demographics
NPI:1447374913
Name:TRAN, GIANG HUONG (DISPENSING OPTICIA)
Entity type:Individual
Prefix:MRS
First Name:GIANG
Middle Name:HUONG
Last Name:TRAN
Suffix:
Gender:F
Credentials:DISPENSING OPTICIA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18541 SHERMAN WAY
Mailing Address - Street 2:STE. 105
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-4152
Mailing Address - Country:US
Mailing Address - Phone:818-344-5588
Mailing Address - Fax:818-344-2053
Practice Address - Street 1:18541 SHERMAN WAY
Practice Address - Street 2:STE. 105
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-4152
Practice Address - Country:US
Practice Address - Phone:818-344-5588
Practice Address - Fax:818-344-2053
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACL1625156FC0800X
CASL5527156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered156FC0800XEye and Vision Services ProvidersTechnician/TechnologistContact Lens
Not Answered156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADX0041810Medicaid
CA1965OtherMEDICAL EYE SERVICE
CAOP0969OtherEYEMED