MEDICARE: LINDA DANGTRAN RPH

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	RPH55590	CA

General Provider Information

NPI Number	:	1396157483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA DANGTRAN RPH

Provider Business Mailing Address
First Line	:	270 SUNSET AVE
Second Line	:
City	:	SUISUN CITY
State	:	CA
Zip	:	94585-1766
Country	:	US
Telephone Number	:	707-426-1274
Fax Number	:	707-426-3280

Provider Business Practice Location Address
First Line	:	270 SUNSET AVE
Second Line	:
City	:	SUISUN CITY
State	:	CA
Zip	:	94585-1766
Country	:	US
Telephone Number	:	707-426-1274
Fax Number	:	707-426-3280

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

Provider Enumeration Date	:	05/23/2014
Last Update Date	:	05/23/2014

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