Healthcare Provider Details

I. General information

NPI: 1366103426
Provider Name (Legal Business Name): BINHYEN THAI TRAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: YEN TRAN PHARMD

II. Dates (important events)

Enumeration Date: 12/31/2021
Last Update Date: 05/24/2026
Certification Date: 05/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42150 WASHINGTON ST
BERMUDA DUNES CA
92203-9611
US

IV. Provider business mailing address

42150 WASHINGTON ST
BERMUDA DUNES CA
92203-9611
US

V. Phone/Fax

Practice location:
  • Phone: 760-200-0843
  • Fax:
Mailing address:
  • Phone: 760-200-0843
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number85808
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number85808
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: