Provider Demographics
NPI:1720083272
Name:TRAN, THANG (PHARM D)
Entity Type:Individual
Prefix:MR
First Name:THANG
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18682 BEACH BLVD
Mailing Address - Street 2:STE 115
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-2049
Mailing Address - Country:US
Mailing Address - Phone:714-887-9500
Mailing Address - Fax:714-887-9400
Practice Address - Street 1:18682 BEACH BLVD
Practice Address - Street 2:STE 115
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-2049
Practice Address - Country:US
Practice Address - Phone:714-887-9500
Practice Address - Fax:714-887-9400
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41172183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5386510001Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER