Provider Demographics
NPI:1114764529
Name:TRAN, LUCAS LOC (PHARMD)
Entity type:Individual
Prefix:
First Name:LUCAS
Middle Name:LOC
Last Name:TRAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:LOC
Other - Middle Name:BA
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6681 KIWI CIR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-5711
Mailing Address - Country:US
Mailing Address - Phone:714-592-6796
Mailing Address - Fax:
Practice Address - Street 1:301 E 17TH ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92706-2804
Practice Address - Country:US
Practice Address - Phone:714-592-6796
Practice Address - Fax:714-465-9744
Is Sole Proprietor?:No
Enumeration Date:2024-07-12
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA89326183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist