Provider Demographics
NPI:1922564723
Name:TRAN, HUONG TUYET
Entity Type:Individual
Prefix:
First Name:HUONG
Middle Name:TUYET
Last Name:TRAN
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 1:800 W WHITTIER BLVD
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-4736
Mailing Address - Country:US
Mailing Address - Phone:323-278-9098
Mailing Address - Fax:323-278-0113
Practice Address - Street 1:800 W WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-4736
Practice Address - Country:US
Practice Address - Phone:323-278-9098
Practice Address - Fax:323-278-0113
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-16
Last Update Date:2019-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49198183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist