Healthcare Provider Details

I. General information

NPI: 1467159244
Provider Name (Legal Business Name): CHRISTINE TRAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2023
Last Update Date: 02/13/2023
Certification Date: 02/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4002 VISTA WAY
OCEANSIDE CA
92056-4506
US

IV. Provider business mailing address

8767 LA ZANA CT
FOUNTAIN VALLEY CA
92708-3329
US

V. Phone/Fax

Practice location:
  • Phone: 760-940-3012
  • Fax:
Mailing address:
  • Phone: 310-938-9766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License Number75844
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: