Provider Demographics
NPI:1720534324
Name:TA, TRAN BUU (PHARMD)
Entity Type:Individual
Prefix:
First Name:TRAN
Middle Name:BUU
Last Name:TA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39400 PASEO PADRE PARKWAY
Mailing Address - Street 2:KAISER PERMANENTE PHARMACY #161
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538
Mailing Address - Country:US
Mailing Address - Phone:510-248-3352
Mailing Address - Fax:
Practice Address - Street 1:39400 PASEO PADRE PARKWAY
Practice Address - Street 2:KAISER PERMANENTE PHARMACY #161
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538
Practice Address - Country:US
Practice Address - Phone:510-248-3352
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA67519183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist