Healthcare Provider Details

I. General information

NPI: 1083922736
Provider Name (Legal Business Name): KATIE NGUYEN TRAN PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2010
Last Update Date: 09/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 AIRPORT DR
BAKERSFIELD CA
93308-3995
US

IV. Provider business mailing address

715 AIRPORT DR
BAKERSFIELD CA
93308-3995
US

V. Phone/Fax

Practice location:
  • Phone: 661-392-7059
  • Fax: 661-392-7091
Mailing address:
  • Phone: 661-392-7059
  • Fax: 661-392-7091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number54278
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: