Provider Demographics
NPI:1194181313
Name:DO, TRAM (RPH)
Entity Type:Individual
Prefix:
First Name:TRAM
Middle Name:
Last Name:DO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11729 IMPERIAL HWY
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-2819
Mailing Address - Country:US
Mailing Address - Phone:652-929-6380
Mailing Address - Fax:562-929-6316
Practice Address - Street 1:11729 IMPERIAL HWY
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-2819
Practice Address - Country:US
Practice Address - Phone:652-929-6380
Practice Address - Fax:562-929-6316
Is Sole Proprietor?:No
Enumeration Date:2016-01-04
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA68089183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA68089OtherCALIFORNIA PHARMACIST LICENSE NUMBER