Organization
GORDON'S FAIRVIEW PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAU VAN TRAN RPH (OWER)
(714) 389-4826
Entity
Organization
Contact information
Practice address
2600 WALNUT AVE UNIT F, TUSTIN, CA 92780-7032
(714) 389-4826
(714) 389-4821
Mailing address
2600 WALNUT AVE UNIT F, TUSTIN, CA 92780-7032
(714) 389-4826
(714) 389-4821
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHY46099
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0525494
NABP
—
05
—
1558418152
—
CA
05
—
PHA460990
—
CA
01
—
PHY46099
PHARMACY LICENSE
CA
Enumeration date
01/04/2007
Last updated
03/07/2023
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