MEDICARE: BINHYEN THAI 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
1	183500000X	Pharmacist	85808	CA

General Provider Information

NPI Number	:	1366103426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BINHYEN THAI TRAN

Provider Business Mailing Address
First Line	:	7460 VALARIA DR
Second Line	:
City	:	HIGHLAND
State	:	CA
Zip	:	92346-3449
Country	:	US
Telephone Number	:	714-487-8763
Fax Number	:

Provider Business Practice Location Address
First Line	:	610 W TEFFT ST
Second Line	:
City	:	NIPOMO
State	:	CA
Zip	:	93444-9187
Country	:	US
Telephone Number	:	805-929-2740
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/31/2021
Last Update Date	:	12/31/2021

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Directions to “ BINHYEN THAI TRAN ” Practice Location

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