Healthcare Provider Details

I. General information

NPI: 1275762148
Provider Name (Legal Business Name): TRAN NGOC TRAN PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2009
Last Update Date: 07/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

JUNCTION OF STATE HWY 371 AND NAVAJO RT 9
CROWNPOINT NM
87313
US

IV. Provider business mailing address

3173 WHITELEAF WAY
SAN JOSE CA
95148-3061
US

V. Phone/Fax

Practice location:
  • Phone: 505-786-5291
  • Fax:
Mailing address:
  • Phone: 408-565-5787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number56132
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: