Provider Demographics
NPI:1033283866
Name:TRAN, HONG THANH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:HONG
Middle Name:THANH
Last Name:TRAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 N WATERMAN AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92404-4811
Mailing Address - Country:US
Mailing Address - Phone:909-963-1836
Mailing Address - Fax:909-494-5582
Practice Address - Street 1:2150 N WATERMAN AVE STE 302
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92404-4811
Practice Address - Country:US
Practice Address - Phone:909-963-1836
Practice Address - Fax:909-494-5582
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 52824183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist