Healthcare Provider Details

I. General information

NPI: 1033678537
Provider Name (Legal Business Name): TRAM THUY DUONG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2019
Last Update Date: 03/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2646 ALLEN RD
BAKERSFIELD CA
93314-9542
US

IV. Provider business mailing address

136 S DELANO ST APT 2
ANAHEIM CA
92804-1733
US

V. Phone/Fax

Practice location:
  • Phone: 661-587-0275
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number80337
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: