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NPI Code Detail

MEDICARE: THANH TRAN

MEDICARE: THANH 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
11835P1200XPharmacotherapy Pharmacist18330NV

General Provider Information

NPI Number : 1902279045
Entity Type Code : Individual
Provider Name (Legal Business Name) : THANH TRAN
Provider Business Mailing Address
First Line : 9463 BALTINGLASS ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89123-6253
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4905 W TROPICANA AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-5077
Country : US
Telephone Number : 702-889-0922
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/11/2015
Last Update Date : 11/11/2015

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Directions to “ THANH TRAN ” Practice Location

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