Healthcare Provider Details

I. General information

NPI: 1255749768
Provider Name (Legal Business Name): BINH TRAN PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2014
Last Update Date: 07/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39940 10TH ST W
PALMDALE CA
93551-3002
US

IV. Provider business mailing address

39940 10TH ST W
PALMDALE CA
93551-3002
US

V. Phone/Fax

Practice location:
  • Phone: 661-575-9289
  • Fax: 661-575-9533
Mailing address:
  • Phone: 661-575-9289
  • Fax: 661-575-9533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number09540
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number41093
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: