Provider Demographics
NPI:1063407302
Name:TRAN, SHERMAN NAM (MD)
Entity type:Individual
Prefix:DR
First Name:SHERMAN
Middle Name:NAM
Last Name:TRAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:NAM
Other - Middle Name:HUU
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:429 LLEWELLYN AVE
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-1948
Mailing Address - Country:US
Mailing Address - Phone:408-364-1616
Mailing Address - Fax:408-378-6775
Practice Address - Street 1:429 LLEWELLYN AVE
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-1948
Practice Address - Country:US
Practice Address - Phone:408-364-1616
Practice Address - Fax:408-378-6775
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-13
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG81800208100000X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG42637Medicare UPIN