Provider Demographics
NPI:1366103426
Name:TRAN, BINHYEN THAI
Entity type:Individual
Prefix:
First Name:BINHYEN
Middle Name:THAI
Last Name:TRAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:YEN
Other - Middle Name:
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:7460 VALARIA DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:CA
Mailing Address - Zip Code:92346-3449
Mailing Address - Country:US
Mailing Address - Phone:714-487-8763
Mailing Address - Fax:
Practice Address - Street 1:610 W TEFFT ST
Practice Address - Street 2:
Practice Address - City:NIPOMO
Practice Address - State:CA
Practice Address - Zip Code:93444-9187
Practice Address - Country:US
Practice Address - Phone:805-929-2740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-31
Last Update Date:2021-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA85808183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist