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General NPI Number Information
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NPI Number | 1871938068
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Entity Type | Individual
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Provider Name | TRI MINH TRAN PHARMACY DOCTORATE
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Gender | Male
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Dates
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Enumeration Date | 05/02/2013
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Last Update Date | 02/13/2014
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Provider Practice Location Address
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Address Line | 11983 HAWTHORNE BLVD
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City | HAWTHORNE
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State | CA
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Zip | 90250-3015
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Country | US
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Telephone | 310-349-0130
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Fax |
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Provider Business Mailing Address
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Address Line | 15914 BENICHIA CIR
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-1001
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Country | US
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Telephone | 262-664-3979
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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 | 67990
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License Number State | CA
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