Healthcare Provider Details

I. General information

NPI: 1740809284
Provider Name (Legal Business Name): BECKY LE-XUAN TRAN CPHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2020
Last Update Date: 04/14/2020
Certification Date: 04/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2131 W 3RD ST
LOS ANGELES CA
90057-1901
US

IV. Provider business mailing address

8951 BLACKHEATH CIR
WESTMINSTER CA
92683-6823
US

V. Phone/Fax

Practice location:
  • Phone: 213-484-7111
  • Fax:
Mailing address:
  • Phone: 714-902-4482
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number28936
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: