Provider Demographics
NPI:1508118530
Name:THAI, TRINA (PHARMD)
Entity Type:Individual
Prefix:
First Name:TRINA
Middle Name:
Last Name:THAI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14250 CHINO HILLS PKWY
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-4832
Mailing Address - Country:US
Mailing Address - Phone:909-628-3400
Mailing Address - Fax:909-628-3477
Practice Address - Street 1:14250 CHINO HILLS PKWY
Practice Address - Street 2:
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-4832
Practice Address - Country:US
Practice Address - Phone:909-628-3400
Practice Address - Fax:909-628-3477
Is Sole Proprietor?:No
Enumeration Date:2012-10-15
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62090183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist