Individual provider Active NPI

Michael Dung Tran

  • Pharmacist
  • Gardena, CA
National Provider Identifier
1972107175
Registry record updated Nov 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
83696 Issued in CA
Practice address
2169 W Redondo Beach Blvd
Gardena, CA 90247-3625
Phone
(310) 515-3783
NPI assigned
Nov 28, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 83696 CA Primary

Addresses

Primary practice location

2169 W Redondo Beach Blvd
Gardena, CA 90247-3625

Mailing address

2169 W Redondo Beach Blvd
Gardena, CA 90247-3625
Phone (310) 515-3783

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

NPI Registry JSON

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

{
    "created_epoch": "1606521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606521600000",
    "number": "1972107175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2169 W REDONDO BEACH BLVD",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902473625",
            "telephone_number": "310-515-3783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2169 W REDONDO BEACH BLVD",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902473625",
            "telephone_number": "310-515-3783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "MICHAEL",
        "middle_name": "DUNG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-28",
        "last_updated": "2020-11-28",
        "certification_date": "2020-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "83696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2020; 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.