Provider Demographics
NPI:1316266158
Name:TRAN, TAMMY T (PHARMACIST)
Entity type:Individual
Prefix:DR
First Name:TAMMY
Middle Name:T
Last Name:TRAN
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2300 HARBOR BLVD
Mailing Address - Street 2:SUITE G
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-6250
Mailing Address - Country:US
Mailing Address - Phone:949-645-7331
Mailing Address - Fax:949-645-7214
Practice Address - Street 1:2300 HARBOR BLVD
Practice Address - Street 2:SUITE G
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-6250
Practice Address - Country:US
Practice Address - Phone:949-645-7331
Practice Address - Fax:949-645-7214
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-18
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51306183500000X
NV14610183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist