Healthcare Provider Details

I. General information

NPI: 1033526173
Provider Name (Legal Business Name): HUNG D TRAN PHARM.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2014
Last Update Date: 07/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6074 N 1ST ST
FRESNO CA
93710-5405
US

IV. Provider business mailing address

6074 N 1ST ST
FRESNO CA
93710-5405
US

V. Phone/Fax

Practice location:
  • Phone: 559-431-5231
  • Fax: 559-431-0224
Mailing address:
  • Phone: 559-431-5231
  • Fax: 559-431-0224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number67935
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: