Provider Demographics
NPI:1225669872
Name:VO, TRANG NGUYEN (RPH)
Entity Type:Individual
Prefix:
First Name:TRANG
Middle Name:NGUYEN
Last Name:VO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:TRANG
Other - Middle Name:PHUONG
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:150 W CARSON ST
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90745-2601
Mailing Address - Country:US
Mailing Address - Phone:310-549-6500
Mailing Address - Fax:310-549-7287
Practice Address - Street 1:150 W CARSON ST
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90745-2601
Practice Address - Country:US
Practice Address - Phone:310-549-6500
Practice Address - Fax:310-549-7287
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-03
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA72251183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist