Healthcare Provider Details

I. General information

NPI: 1427376482
Provider Name (Legal Business Name): JANINE-THIENTRANG DOAN TRAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2010
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 E 17TH ST
COSTA MESA CA
92627-3252
US

IV. Provider business mailing address

3 BRIDGEWOOD
IRVINE CA
92604-4507
US

V. Phone/Fax

Practice location:
  • Phone: 949-645-1277
  • Fax: 949-645-4738
Mailing address:
  • Phone: 949-981-8622
  • Fax: 949-645-4738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number53303
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: