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General NPI Number Information
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NPI Number | 1538799986
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Entity Type | Individual
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Provider Name | KHUONG ANH TRAN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 01/23/2020
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Last Update Date | 01/23/2020
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Provider Practice Location Address
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Address Line | 3490 N STOCKTON HILL RD
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City | KINGMAN
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State | AZ
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Zip | 86409-3680
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Country | US
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Telephone | 928-757-3338
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Fax |
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Provider Business Mailing Address
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Address Line | 7950 DARBY AVE
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City | LAS VEGAS
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State | NV
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Zip | 89117-2520
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Country | US
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Telephone | 714-391-1718
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | S024240
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License Number State | AZ
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