MEDICARE: DR. ALBERTINO JASON TRAN PHARM.D

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	183500000X	Pharmacist	69035	CA
2	183500000X	Pharmacist	54191	TX

General Provider Information

NPI Number	:	1376975755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALBERTINO JASON TRAN PHARM.D

Provider Business Mailing Address
First Line	:	3828 BILLMAN ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92115-7007
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3131 CAMINO DEL RIO N
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-5701
Country	:	US
Telephone Number	:	619-800-8113
Fax Number	:

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

Provider Enumeration Date	:	08/07/2013
Last Update Date	:	10/29/2016

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