Provider Demographics
NPI:1154596880
Name:TRAN, HANH VIVIAN (DDS)
Entity type:Individual
Prefix:DR
First Name:HANH
Middle Name:VIVIAN
Last Name:TRAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2403 S MORAY AVE
Mailing Address - Street 2:SUITE #2
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90732-4342
Mailing Address - Country:US
Mailing Address - Phone:310-832-4203
Mailing Address - Fax:
Practice Address - Street 1:2403 S MORAY AVE
Practice Address - Street 2:SUITE #2
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90732-4342
Practice Address - Country:US
Practice Address - Phone:310-832-4203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49687122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist