Provider Demographics
NPI:1013632546
Name:DOAN, TRANG THI DOAN (RPH)
Entity Type:Individual
Prefix:
First Name:TRANG
Middle Name:THI DOAN
Last Name:DOAN
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 1:15990 BROOKHURST ST
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-1014
Mailing Address - Country:US
Mailing Address - Phone:714-775-3974
Mailing Address - Fax:
Practice Address - Street 1:15990 BROOKHURST ST
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-1014
Practice Address - Country:US
Practice Address - Phone:714-775-3974
Practice Address - Fax:714-596-4912
Is Sole Proprietor?:No
Enumeration Date:2022-10-06
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86955183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist