Basic Information
| Provider Information | |||||||||
| NPI: | 1871956581 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | QUAN | ||||||||
| FirstName: | ANN | ||||||||
| MiddleName: | VAN ANH TRONG | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10790 RANCHO BERNARDO RD | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921275705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6192452350 | ||||||||
| FaxNumber: | 6192452922 | ||||||||
| Practice Location | |||||||||
| Address1: | 2205 VISTA WAY # 330 | ||||||||
| Address2: | |||||||||
| City: | OCEANSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920545661 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7607045600 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2016 | ||||||||
| LastUpdateDate: | 09/28/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207W00000X | ME144407 | FL | N | Allopathic & Osteopathic Physicians | Ophthalmology | 207W00000X | A171611 | CA | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.