Healthcare Provider Details

I. General information

NPI: 1992286397
Provider Name (Legal Business Name): CHRISTINE VIVI TRAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2018
Last Update Date: 08/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

78218 VARNER RD
PALM DESERT CA
92211-4134
US

IV. Provider business mailing address

550 S REYNOLDS PL
ANAHEIM CA
92806-4220
US

V. Phone/Fax

Practice location:
  • Phone: 760-200-4382
  • Fax:
Mailing address:
  • Phone: 714-398-4768
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number78275
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: