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General NPI Number Information
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NPI Number | 1265093025
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Entity Type | Individual
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Provider Name | TRUNG MINH TRAN
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Gender | Male
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Dates
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Enumeration Date | 06/24/2019
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Last Update Date | 06/24/2019
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Provider Practice Location Address
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Address Line | 377 32ND AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94121-1738
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Country | US
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Telephone | 415-666-3153
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Fax |
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Provider Business Mailing Address
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Address Line | 270 WINNIPEG TER
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City | FREMONT
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State | CA
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Zip | 94538-5937
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Country | US
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Telephone | 510-509-4018
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 80537
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License Number State | CA
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