Basic Information
Provider Information
NPI: 1003002718
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LA
FirstName: TRANG
MiddleName: H.
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 275 W MACARTHUR
Address2:  
City: OAKLAND
State: CA
PostalCode: 946115641
CountryCode: US
TelephoneNumber: 5107521000
FaxNumber: 6507258231
Practice Location
Address1: 275 W MACARTHUR
Address2:  
City: OAKLAND
State: CA
PostalCode: 946115641
CountryCode: US
TelephoneNumber: 5107521000
FaxNumber: 6507258231
Other Information
ProviderEnumerationDate: 09/18/2007
LastUpdateDate: 09/18/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0001XA96662CAY Allopathic & Osteopathic PhysiciansRadiologyRadiation Oncology

No ID Information.


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