Provider Demographics
NPI:1427376482
Name:TRAN, JANINE-THIENTRANG DOAN
Entity Type:Individual
Prefix:
First Name:JANINE-THIENTRANG
Middle Name:DOAN
Last Name:TRAN
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 1:542 VENETO
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-5957
Mailing Address - Country:US
Mailing Address - Phone:714-636-1143
Mailing Address - Fax:714-636-1856
Practice Address - Street 1:12897 HARBOR BLVD
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-5808
Practice Address - Country:US
Practice Address - Phone:714-636-1143
Practice Address - Fax:714-636-1856
Is Sole Proprietor?:No
Enumeration Date:2010-05-14
Last Update Date:2010-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53303183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist