MEDICARE: DR. THOA THI TRINH 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	59145	CA

General Provider Information

NPI Number	:	1578847208
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOA THI TRINH RPH

Provider Business Mailing Address
First Line	:	3630 SAN PABLO DAM RD
Second Line	:
City	:	EL SOBRANTE
State	:	CA
Zip	:	94803-2730
Country	:	US
Telephone Number	:	510-758-2365
Fax Number	:	510-758-8590

Provider Business Practice Location Address
First Line	:	3630 SAN PABLO DAM RD
Second Line	:
City	:	EL SOBRANTE
State	:	CA
Zip	:	94803-2730
Country	:	US
Telephone Number	:	510-758-2365
Fax Number	:	510-758-8590

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

Provider Enumeration Date	:	09/29/2011
Last Update Date	:	09/29/2011

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