MEDICARE: MINH THOA THI TRAN

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	1835P0200X	Pediatric Pharmacist	RPH41285	CA

General Provider Information

NPI Number	:	1558872408
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MINH THOA THI TRAN

Provider Business Mailing Address
First Line	:	725 WELCH RD
Second Line	:
City	:	PALO ALTO
State	:	CA
Zip	:	94304-1601
Country	:	US
Telephone Number	:	650-497-8289
Fax Number	:	650-497-8974

Provider Business Practice Location Address
First Line	:	725 WELCH RD
Second Line	:
City	:	PALO ALTO
State	:	CA
Zip	:	94304-1601
Country	:	US
Telephone Number	:	650-497-8289
Fax Number	:	650-497-8974

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

Provider Enumeration Date	:	10/18/2017
Last Update Date	:	10/18/2017

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Directions to “ MINH THOA THI TRAN ” Practice Location

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