Provider Demographics
NPI:1558648253
Name:TRAN, CAROLINE JULIA (RPH)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:JULIA
Last Name:TRAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 WESTMINSTER MALL
Mailing Address - Street 2:T-2304
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-4984
Mailing Address - Country:US
Mailing Address - Phone:714-657-1352
Mailing Address - Fax:714-657-1362
Practice Address - Street 1:200 WESTMINSTER MALL
Practice Address - Street 2:T-2304
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-4984
Practice Address - Country:US
Practice Address - Phone:714-657-1352
Practice Address - Fax:714-657-1362
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-08
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64752183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist