Provider Demographics
NPI:1891307369
Name:TRAN, MAY TRUC-VAN (PHARMACIST STUDENT)
Entity Type:Individual
Prefix:
First Name:MAY
Middle Name:TRUC-VAN
Last Name:TRAN
Suffix:
Gender:F
Credentials:PHARMACIST STUDENT
Other - Prefix:
Other - First Name:VAN
Other - Middle Name:TRUC
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13412 KERRY ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92844-2417
Mailing Address - Country:US
Mailing Address - Phone:480-685-0843
Mailing Address - Fax:
Practice Address - Street 1:13412 KERRY ST
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92844-2417
Practice Address - Country:US
Practice Address - Phone:480-685-0843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46630390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program