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Individual
DR. QUYEN TRAN IMMOOS
Active
Individual
DR. QUYEN TRAN IMMOOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
12530T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SDO125300
—
CA
01
—
WOP12530A
MEDICARE PIN SECOND LOCATION
CA
Enumeration date
12/09/2005
Last updated
12/12/2011
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