MEDICARE: THANH V 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	13532	NV

General Provider Information

NPI Number	:	1518240977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THANH V TRAN PHARM D

Provider Business Mailing Address
First Line	:	2880 S TORREY PINES DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-5143
Country	:	US
Telephone Number	:	702-355-3740
Fax Number	:	702-871-3314

Provider Business Practice Location Address
First Line	:	2880 S TORREY PINES DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-5143
Country	:	US
Telephone Number	:	702-355-3740
Fax Number	:	702-871-3314

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

Provider Enumeration Date	:	09/22/2011
Last Update Date	:	09/22/2011

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