MEDICARE: KHUONG ANH 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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	S024240	AZ
2	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	20214	NV

General Provider Information

NPI Number	:	1538799986
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KHUONG ANH TRAN PHARMD

Provider Business Mailing Address
First Line	:	10309 WHISPY WILLOW WAY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89135-2092
Country	:	US
Telephone Number	:	714-391-1718
Fax Number	:

Provider Business Practice Location Address
First Line	:	10100 W TROPICANA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-8459
Country	:	US
Telephone Number	:	702-220-7911
Fax Number	:	702-220-3778

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

Provider Enumeration Date	:	01/23/2020
Last Update Date	:	05/27/2026

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