MEDICARE: HARBOR HEALTHY LIVING PHARMACY INC

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	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PHY57969	OTHER	CA	BOARD OF PHARMACY
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720678675
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARBOR HEALTHY LIVING PHARMACY INC

Provider Business Mailing Address
First Line	:	5015 W EDINGER AVE STE B
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92704-1968
Country	:	US
Telephone Number	:	657-247-0851
Fax Number	:	657-247-0481

Provider Business Practice Location Address
First Line	:	5015 W EDINGER AVE STE B
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92704-1968
Country	:	US
Telephone Number	:	657-247-0851
Fax Number	:	657-247-0481

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MR. THINH HUNG TRAN
Credential	:	PHARM D
Telephone Number	:	657-247-0851

Provider Enumeration Date	:	01/25/2021
Last Update Date	:	03/10/2026

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