Provider Demographics
NPI:1194333203
Name:DO, TRINITY THIENANH KHOA (PHARMD, MBA)
Entity type:Individual
Prefix:
First Name:TRINITY THIENANH
Middle Name:KHOA
Last Name:DO
Suffix:
Gender:F
Credentials:PHARMD, MBA
Other - Prefix:
Other - First Name:TRINITY
Other - Middle Name:
Other - Last Name:DO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:47699 CALLE DIAMANTE
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-6692
Mailing Address - Country:US
Mailing Address - Phone:310-951-6703
Mailing Address - Fax:
Practice Address - Street 1:5601 E RAMON RD
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92264-3605
Practice Address - Country:US
Practice Address - Phone:760-322-1488
Practice Address - Fax:760-322-8059
Is Sole Proprietor?:No
Enumeration Date:2020-07-15
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61065183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist