Provider Demographics
NPI:1326166281
Name:TRAN, HIEU DUC (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:HIEU
Middle Name:DUC
Last Name:TRAN
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9081 BOLSA AVE
Mailing Address - Street 2:SUITE # 108
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5518
Mailing Address - Country:US
Mailing Address - Phone:714-379-5072
Mailing Address - Fax:714-379-5074
Practice Address - Street 1:9081 BOLSA AVE
Practice Address - Street 2:SUITE # 108
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-5518
Practice Address - Country:US
Practice Address - Phone:714-379-5072
Practice Address - Fax:714-379-5074
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 40511183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist