Provider Demographics
NPI:1841581493
Name:TRAN, VANKHANH (PHARMD)
Entity Type:Individual
Prefix:
First Name:VANKHANH
Middle Name:
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 1:26 AGOSTINO
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-8413
Mailing Address - Country:US
Mailing Address - Phone:617-233-4871
Mailing Address - Fax:
Practice Address - Street 1:26 AGOSTINO
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-8413
Practice Address - Country:US
Practice Address - Phone:617-233-4871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-29
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH27131183500000X
CA68670183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist