Healthcare Provider Details

I. General information

NPI: 1750102406
Provider Name (Legal Business Name): THO TRAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2024
Last Update Date: 10/24/2024
Certification Date: 10/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 COCHRANE PLZ
MORGAN HILL CA
95037-2812
US

IV. Provider business mailing address

1129 LOUPE AVE
SAN JOSE CA
95121-2417
US

V. Phone/Fax

Practice location:
  • Phone: 408-782-2360
  • Fax:
Mailing address:
  • Phone: 408-726-5277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number88126
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: