Provider Demographics
NPI:1801335211
Name:TRAN, THINH DUC (PHARMD)
Entity type:Individual
Prefix:
First Name:THINH
Middle Name:DUC
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 1:8322 BOLSA AVE
Mailing Address - Street 2:APT.2
Mailing Address - City:MIDWAY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92655-1303
Mailing Address - Country:US
Mailing Address - Phone:714-399-5493
Mailing Address - Fax:
Practice Address - Street 1:8322 BOLSA AVE
Practice Address - Street 2:APT.2
Practice Address - City:MIDWAY CITY
Practice Address - State:CA
Practice Address - Zip Code:92655-1303
Practice Address - Country:US
Practice Address - Phone:714-399-5493
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-17
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA76253183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist