Provider Demographics
NPI:1063515534
Name:TRAN, VU QUANG (OD)
Entity type:Individual
Prefix:DR
First Name:VU
Middle Name:QUANG
Last Name:TRAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:9122 PANORAMA DR
Mailing Address - Street 2:
Mailing Address - City:PERRY HALL
Mailing Address - State:MD
Mailing Address - Zip Code:21128-8948
Mailing Address - Country:US
Mailing Address - Phone:408-712-6585
Mailing Address - Fax:410-882-9990
Practice Address - Street 1:8118 PERRY HILLS RD.
Practice Address - Street 2:
Practice Address - City:WHITE MARSH
Practice Address - State:MD
Practice Address - Zip Code:21236
Practice Address - Country:US
Practice Address - Phone:410-882-9990
Practice Address - Fax:410-882-9972
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDTA 1957152W00000X
CAOPT 12869152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist