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NPI Code Detail

MEDICARE: REGINA MYRA TRAN

MEDICARE:   REGINA MYRA 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
1183500000XPharmacist85368CA

General Provider Information

NPI Number : 1962165977
Entity Type Code : Individual
Provider Name (Legal Business Name) : REGINA MYRA TRAN
Provider Business Mailing Address
First Line : 25281 PARK AVE APT L22
Second Line :
City : LOMA LINDA
State : CA
Zip : 92354-2373
Country : US
Telephone Number : 714-724-2028
Fax Number :
Provider Business Practice Location Address
First Line : 22456 BARTON RD
Second Line :
City : GRAND TERRACE
State : CA
Zip : 92313-5009
Country : US
Telephone Number : 909-824-2619
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2021
Last Update Date : 10/17/2021

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Directions to “ REGINA MYRA TRAN ” Practice Location

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