Provider Demographics
NPI:1972051902
Name:TRINH, KHOA
Entity Type:Individual
Prefix:
First Name:KHOA
Middle Name:
Last Name:TRINH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1442 S PARKER RD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-2707
Mailing Address - Country:US
Mailing Address - Phone:303-481-3520
Mailing Address - Fax:
Practice Address - Street 1:1442 S PARKER RD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-2707
Practice Address - Country:US
Practice Address - Phone:303-481-3520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-19
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX59076183500000X
COPHA.0022507183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist