Provider Demographics
NPI:1164722245
Name:TRAN, DAT TRI (PHARMD)
Entity Type:Individual
Prefix:
First Name:DAT
Middle Name:TRI
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 1:2345 E VALLEY PKWY
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92027-2715
Mailing Address - Country:US
Mailing Address - Phone:760-489-0981
Mailing Address - Fax:760-489-9890
Practice Address - Street 1:2345 E VALLEY PKWY
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92027-2715
Practice Address - Country:US
Practice Address - Phone:760-489-0981
Practice Address - Fax:760-489-9890
Is Sole Proprietor?:No
Enumeration Date:2010-10-23
Last Update Date:2010-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49661183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist