Provider Demographics
NPI:1144620048
Name:TU, TRAN
Entity Type:Individual
Prefix:
First Name:TRAN
Middle Name:
Last Name:TU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6336 COLLEGE GROVE WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92115-7244
Mailing Address - Country:US
Mailing Address - Phone:619-858-0097
Mailing Address - Fax:619-858-0107
Practice Address - Street 1:6336 COLLEGE GROVE WAY
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92115-7244
Practice Address - Country:US
Practice Address - Phone:619-858-0097
Practice Address - Fax:619-858-0107
Is Sole Proprietor?:No
Enumeration Date:2014-08-27
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 57027183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist