Provider Demographics
NPI:1508179599
Name:SON, TRANG NGOC (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TRANG
Middle Name:NGOC
Last Name:SON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2108 CYRIL AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90032-3808
Mailing Address - Country:US
Mailing Address - Phone:310-639-1278
Mailing Address - Fax:
Practice Address - Street 1:1001 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90222-3647
Practice Address - Country:US
Practice Address - Phone:310-639-1278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-19
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58770183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist