Provider Demographics
NPI:1699365130
Name:TRAN, KAITLYNN THUANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:KAITLYNN
Middle Name:THUANN
Last Name:TRAN
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 1:14211 EUCLID ST STE A
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-4992
Mailing Address - Country:US
Mailing Address - Phone:714-530-3833
Mailing Address - Fax:
Practice Address - Street 1:14211 EUCLID ST STE A
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-4992
Practice Address - Country:US
Practice Address - Phone:714-530-3833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-19
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60428183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist