Provider Demographics
NPI:1225388390
Name:TRAN, HONG THI DIEM (PHARMD)
Entity type:Individual
Prefix:DR
First Name:HONG
Middle Name:THI DIEM
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 1:95 HOLGER WAY
Mailing Address - Street 2:TARGET-2581
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95134-1377
Mailing Address - Country:US
Mailing Address - Phone:408-834-1527
Mailing Address - Fax:
Practice Address - Street 1:95 HOLGER WAY
Practice Address - Street 2:TARGET-2581
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95134
Practice Address - Country:US
Practice Address - Phone:408-834-1527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA67987183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist