Provider Demographics
NPI:1740643964
Name:TRAN, KEVIN QUANG (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:QUANG
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 1:10810 WARNER AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-3848
Mailing Address - Country:US
Mailing Address - Phone:714-465-2431
Mailing Address - Fax:714-465-9744
Practice Address - Street 1:10810 WARNER AVE STE 3
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-3848
Practice Address - Country:US
Practice Address - Phone:714-465-2431
Practice Address - Fax:714-465-9744
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-04
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY56316183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist