Provider Demographics
NPI:1447677398
Name:TRAN, HOA TAN (SOIDC)
Entity type:Individual
Prefix:
First Name:HOA
Middle Name:TAN
Last Name:TRAN
Suffix:
Gender:M
Credentials:SOIDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1636 REGULUS AVE
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23461-2200
Mailing Address - Country:US
Mailing Address - Phone:757-862-0060
Mailing Address - Fax:
Practice Address - Street 1:1636 REGULUS AVE
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23461-2200
Practice Address - Country:US
Practice Address - Phone:757-862-0060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-27
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman