Provider Demographics
NPI:1467995704
Name:TRAN, VINCENT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:
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 1:23500 KASSON RD
Mailing Address - Street 2:ROOM 106 (PHARMACY)
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95376-0400
Mailing Address - Country:US
Mailing Address - Phone:209-835-4141
Mailing Address - Fax:209-830-3807
Practice Address - Street 1:23500 KASSON RD
Practice Address - Street 2:ROOM 106 (PHARMACY)
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376-0400
Practice Address - Country:US
Practice Address - Phone:209-835-4141
Practice Address - Fax:209-830-3807
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-18
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52718183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist