MEDICARE: MINH TRAN PHARM.D

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	118443	MN
2	183500000X	Pharmacist	60969	CA

General Provider Information

NPI Number	:	1902127517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MINH TRAN PHARM.D

Provider Business Mailing Address
First Line	:	PO BOX 12102
Second Line	:
City	:	WESTMINSTER
State	:	CA
Zip	:	92685-2102
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4046 S CENTINELA AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90066-4907
Country	:	US
Telephone Number	:	310-391-8259
Fax Number	:

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

Provider Enumeration Date	:	06/17/2010
Last Update Date	:	06/17/2010

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