Provider Demographics
NPI:1487673752
Name:TRAN, DO (RPH)
Entity Type:Individual
Prefix:MR
First Name:DO
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2221 MARTIN LUTHER KING JR WAY
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-1318
Mailing Address - Country:US
Mailing Address - Phone:510-267-7837
Mailing Address - Fax:510-267-7879
Practice Address - Street 1:2221 MARTIN LUTHER KING JR WAY
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-1318
Practice Address - Country:US
Practice Address - Phone:510-267-7837
Practice Address - Fax:510-267-7879
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37866183500000X
261QV0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered261QV0200XAmbulatory Health Care FacilitiesClinic/CenterVA