MEDICARE: DR. TRANG THIEN VO

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	50598	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1083758155	OTHER	CA	COMMUNITY PHARMACY
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1083758155	OTHER	CA	LUCKY PHARMACY

General Provider Information

NPI Number	:	1770139180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TRANG THIEN VO

Provider Business Mailing Address
First Line	:	34101 FREMONT BLVD
Second Line	:
City	:	FREMONT
State	:	CA
Zip	:	94555-2230
Country	:	US
Telephone Number	:	510-794-0735
Fax Number	:	510-794-0781

Provider Business Practice Location Address
First Line	:	34101 FREMONT BLVD
Second Line	:
City	:	FREMONT
State	:	CA
Zip	:	94555-2230
Country	:	US
Telephone Number	:	510-794-9735
Fax Number	:	510-794-0784

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

Provider Enumeration Date	:	08/12/2019
Last Update Date	:	08/12/2019

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Directions to “ DR. TRANG THIEN VO ” Practice Location

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