Provider Demographics
NPI:1902829062
Name:TRAN, LOC TAN (PHARM-D)
Entity Type:Individual
Prefix:
First Name:LOC
Middle Name:TAN
Last Name:TRAN
Suffix:
Gender:M
Credentials:PHARM-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5694 CALANAS AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89141-3951
Mailing Address - Country:US
Mailing Address - Phone:702-809-3061
Mailing Address - Fax:702-454-3053
Practice Address - Street 1:3760 E SUNSET RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3233
Practice Address - Country:US
Practice Address - Phone:702-458-4004
Practice Address - Fax:702-454-3053
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV14361183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist