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General NPI Number Information
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NPI Number | 1356616254
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Entity Type | Individual
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Provider Name | TERESA HOAI TRAN
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Gender | Female
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Dates
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Enumeration Date | 03/12/2012
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Last Update Date | 03/12/2012
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Provider Practice Location Address
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Address Line | 215 DEININGER CIR
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City | CORONA
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State | CA
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Zip | 92880-1707
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Country | US
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Telephone | 951-493-2368
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Fax |
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Provider Business Mailing Address
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Address Line | 2579 CAMINO DEL PLATA
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City | CORONA
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State | CA
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Zip | 92882-8082
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Country | US
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Telephone |
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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 | 45753
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License Number State | CA
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