Provider Demographics
NPI:1922885482
Name:TRAN, NGOC-CHAU NGUYEN CASEY (RPH)
Entity Type:Individual
Prefix:DR
First Name:NGOC-CHAU
Middle Name:NGUYEN CASEY
Last Name:TRAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1203 N AVALON BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:CA
Mailing Address - Zip Code:90744-2646
Mailing Address - Country:US
Mailing Address - Phone:310-549-1000
Mailing Address - Fax:
Practice Address - Street 1:1203 N AVALON BLVD STE A
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:CA
Practice Address - Zip Code:90744-2646
Practice Address - Country:US
Practice Address - Phone:310-549-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84228183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist