MEDICARE: HUNG NGUYEN TRAN PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835X0200X	Oncology Pharmacist	84854	CA

General Provider Information

NPI Number	:	1083386007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HUNG NGUYEN TRAN PHARMD

Provider Business Mailing Address
First Line	:	4186 W ELLERY WAY
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93722-3557
Country	:	US
Telephone Number	:	559-824-0764
Fax Number	:

Provider Business Practice Location Address
First Line	:	785 N MEDICAL CENTER DR W
Second Line	:
City	:	CLOVIS
State	:	CA
Zip	:	93611-6878
Country	:	US
Telephone Number	:	559-387-1900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2021
Last Update Date	:	10/12/2021

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