Individual
DR. BEATLE THIEN-PHUOC TRAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1029 JEFFERSON BLVD, SUITE A, WEST SACRAMENTO, CA 95691-3344
(916) 371-2022
(916) 371-2027
Mailing address
1029 JEFFERSON BLVD, SUITE A, WEST SACRAMENTO, CA 95691-3344
(916) 371-2022
(916) 371-2027
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
RPH 50909
CA
332B00000X
Durable Medical Equipment & Medical Supplies
5527150001
CA
3336C0003X
Community/Retail Pharmacy
Primary
PHY 470830
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0550017
NCPDP
—
05
—
PHA 470830
—
CA
01
—
PHY 47083
STATE PHARMACY LICENSE
CA
01
—
RPH 50909
PHARMACIST LICENSURE CA
CA
Enumeration date
08/24/2005
Last updated
03/07/2023
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