Provider Demographics
NPI:1780337741
Name:TRAN, JOHNNY JOSEPH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOHNNY
Middle Name:JOSEPH
Last Name:TRAN
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 1:2732 TWIN BRIDGES LN
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95212-2773
Mailing Address - Country:US
Mailing Address - Phone:209-242-4671
Mailing Address - Fax:
Practice Address - Street 1:1032 OAKDALE RD
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-4595
Practice Address - Country:US
Practice Address - Phone:209-577-6060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-31
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84236183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist