Healthcare Provider Details

I. General information

NPI: 1679702211
Provider Name (Legal Business Name): VISTA PHARMA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2009
Last Update Date: 12/26/2025
Certification Date: 12/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15434 BROOKHURST ST
WESTMINSTER CA
92683-7057
US

IV. Provider business mailing address

15434 BROOKHURST ST
WESTMINSTER CA
92683-7057
US

V. Phone/Fax

Practice location:
  • Phone: 714-839-5888
  • Fax: 714-839-7788
Mailing address:
  • Phone: 714-839-5888
  • Fax: 714-839-7788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. PHU H. TRAN
Title or Position: PRESIDENT/CEO/RPH
Credential:
Phone: 714-839-5888