Provider Demographics
NPI:1053901223
Name:TRAN, TRANG (PHARMD)
Entity type:Individual
Prefix:
First Name:TRANG
Middle Name:
Last Name:TRAN
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 1:14124 FOOTHILL BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342-8053
Mailing Address - Country:US
Mailing Address - Phone:818-364-5100
Mailing Address - Fax:818-364-5102
Practice Address - Street 1:14124 FOOTHILL BLVD
Practice Address - Street 2:#102
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342
Practice Address - Country:US
Practice Address - Phone:818-364-5100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-21
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61057183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist