Healthcare Provider Details

I. General information

NPI: 1104027945
Provider Name (Legal Business Name): ERIC H TRAN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6215 SANTA TERESA BLVD
SAN JOSE CA
95119-1436
US

IV. Provider business mailing address

290 HERLONG AVE
SAN JOSE CA
95123-3532
US

V. Phone/Fax

Practice location:
  • Phone: 408-227-2816
  • Fax:
Mailing address:
  • Phone: 408-629-5771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number58930
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: