Healthcare Provider Details

I. General information

NPI: 1952214124
Provider Name (Legal Business Name): ELLEN THUY TRAN PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3558 RUFFIN RD
SAN DIEGO CA
92123-2596
US

IV. Provider business mailing address

1366 CARPINTERIA ST
CHULA VISTA CA
91913-2520
US

V. Phone/Fax

Practice location:
  • Phone: 858-627-5681
  • Fax: 858-252-2802
Mailing address:
  • Phone: 858-627-5681
  • Fax: 858-252-2802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number500509
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: