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NPI Code Detail

MEDICARE: JASON TRAN

MEDICARE: JASON TRAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist79212CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11932141769OTHERCANPI

General Provider Information

NPI Number : 1356805212
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON TRAN
Provider Business Mailing Address
First Line : 6450 PONY EXPRESS TRL
Second Line :
City : POLLOCK PINES
State : CA
Zip : 95726-9601
Country : US
Telephone Number : 530-647-8013
Fax Number : 530-647-1207
Provider Business Practice Location Address
First Line : 6450 PONY EXPRESS TRL
Second Line :
City : POLLOCK PINES
State : CA
Zip : 95726-9601
Country : US
Telephone Number : 530-647-8013
Fax Number : 530-647-1207
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2019
Last Update Date : 01/24/2019

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Directions to “ JASON TRAN ” Practice Location

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