Healthcare Provider Details

I. General information

NPI: 1386583441
Provider Name (Legal Business Name): JIMMY TRAN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6600 BRUCEVILLE RD
SACRAMENTO CA
95823-4671
US

IV. Provider business mailing address

5220 PERCHERON DR
ELK GROVE CA
95757-3278
US

V. Phone/Fax

Practice location:
  • Phone: 916-639-9713
  • Fax:
Mailing address:
  • Phone: 916-639-9713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number75181
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: