Provider Demographics
NPI:1750159869
Name:TRAN, HEIDI VU (PHARM D)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:VU
Last Name:TRAN
Suffix:
Gender:F
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 1:12540 MCCANN DR
Mailing Address - Street 2:
Mailing Address - City:SANTA FE SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:90670-3337
Mailing Address - Country:US
Mailing Address - Phone:909-747-2899
Mailing Address - Fax:
Practice Address - Street 1:12540 MCCANN DR
Practice Address - Street 2:
Practice Address - City:SANTA FE SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:90670-3337
Practice Address - Country:US
Practice Address - Phone:714-664-0518
Practice Address - Fax:714-664-0680
Is Sole Proprietor?:No
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH85717183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist