Provider Demographics
NPI:1568866473
Name:TRAN, DAVIS THANH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DAVIS
Middle Name:THANH
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 1:5713 N PERSHING AVE STE A3
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-4942
Mailing Address - Country:US
Mailing Address - Phone:209-488-7770
Mailing Address - Fax:
Practice Address - Street 1:5713 N PERSHING AVE STE A3
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-4942
Practice Address - Country:US
Practice Address - Phone:209-488-7770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-21
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA645311835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric