Provider Demographics
NPI:1902495781
Name:VO, TIANA THUY-TRAM (PHARM D)
Entity type:Individual
Prefix:
First Name:TIANA
Middle Name:THUY-TRAM
Last Name:VO
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4430 ROCKHOLD AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-1661
Mailing Address - Country:US
Mailing Address - Phone:626-589-3556
Mailing Address - Fax:
Practice Address - Street 1:3600 ROSEMEAD BLVD
Practice Address - Street 2:
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-2066
Practice Address - Country:US
Practice Address - Phone:626-280-4908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-15
Last Update Date:2021-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83743183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist