Individual provider Active NPI

Tra Van Duong

  • Pharmacist
  • San Jose, CA
National Provider Identifier
1609273499
Registry record updated Nov 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
72015 Issued in CA
Practice address
3874 Linton CT
San Jose, CA 95121-1451
Phone
(626) 636-6158
NPI assigned
Nov 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 72015 CA Primary

Addresses

Primary practice location

3874 Linton CT
San Jose, CA 95121-1451

Mailing address

3874 Linton CT
San Jose, CA 95121-1451

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
72015CAMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1416700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416700800000",
    "number": "1609273499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3874 LINTON CT",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951211451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3874 LINTON CT",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951211451",
            "telephone_number": "626-636-6158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUONG",
        "first_name": "TRA",
        "middle_name": "VAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-23",
        "last_updated": "2014-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "72015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.