Healthcare Provider Details

I. General information

NPI: 1982936472
Provider Name (Legal Business Name): KATE HUONG MAI TRAN PHARMD.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2010
Last Update Date: 02/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4501 SAND CREEK RD
ANTIOCH CA
94531-8687
US

IV. Provider business mailing address

1601 BROADWAY ST APT 517
CONCORD CA
94520-2655
US

V. Phone/Fax

Practice location:
  • Phone: 925-813-7280
  • Fax: 925-813-7281
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH 60610
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: