Provider Demographics
NPI:1881686640
Name:TRAN, THO DAC (RPH)
Entity type:Individual
Prefix:MR
First Name:THO
Middle Name:DAC
Last Name:TRAN
Suffix:
Gender:M
Credentials:RPH
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Mailing Address - Street 1:9433 BOLSA AVE
Mailing Address - Street 2:STE B
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5964
Mailing Address - Country:US
Mailing Address - Phone:714-531-8770
Mailing Address - Fax:714-531-0552
Practice Address - Street 1:9433 BOLSA AVE
Practice Address - Street 2:STE. B
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-5964
Practice Address - Country:US
Practice Address - Phone:714-531-8770
Practice Address - Fax:714-531-0552
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-18
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CARPH42377183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0509008OtherNABP#
CAPHA372040Medicaid
CAPHA372040Medicaid
BT2921989OtherDEA#