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General NPI Number Information
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NPI Number | 1164182762
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Entity Type | Individual
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Provider Name | LEON TRAN RPH
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Gender | Male
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Dates
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Enumeration Date | 12/22/2021
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Last Update Date | 12/22/2021
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Provider Practice Location Address
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Address Line | 23975 IRONWOOD AVE
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City | MORENO VALLEY
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State | CA
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Zip | 92557-7153
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Country | US
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Telephone | 951-242-1742
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Fax |
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Provider Business Mailing Address
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Address Line | 12441 LA LINDA CIR
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City | GARDEN GROVE
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State | CA
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Zip | 92841-3232
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Country | US
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Telephone | 714-916-2509
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 85672
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License Number State | CA
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