MEDICARE: TRACY 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	69757	CA

General Provider Information

NPI Number	:	1457765869
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACY TRAN

Provider Business Mailing Address
First Line	:	11768 EMERY ST
Second Line	:
City	:	EL MONTE
State	:	CA
Zip	:	91732-1904
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3745 E FOOTHILL BLVD
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91107-2202
Country	:	US
Telephone Number	:	626-351-0515
Fax Number	:

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

Provider Enumeration Date	:	06/13/2014
Last Update Date	:	03/07/2023

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Directions to “ TRACY TRAN ” Practice Location

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