Provider Demographics
NPI:1801204763
Name:HA, TRAN
Entity Type:Individual
Prefix:
First Name:TRAN
Middle Name:
Last Name:HA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2753 E EASTLAND CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91791-6612
Mailing Address - Country:US
Mailing Address - Phone:626-332-4625
Mailing Address - Fax:626-332-4638
Practice Address - Street 1:2753 E EASTLAND CENTER DR
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91791-6612
Practice Address - Country:US
Practice Address - Phone:626-332-4625
Practice Address - Fax:626-332-4638
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-23
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63618183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist