Loan Kim Thi Tran | Fairfield, CA • PECOS Search

Loan Kim Thi Tran

Pharmacist

Pharmacy Service Providers

101 Bodin Circle, Fairfield, CA 94535

PECOS Enrollment

Based on the most recent information from CMS, provider Loan Kim Thi Tran does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 11:10 AM.

Profile Details

Provider ID
1659906824
Provider Type
Individual
Full Name
Tran, Loan Kim Thi
Gender
Female

Sole Proprietor
No
Enumeration Date
3/9/2020
Last Updated
3/9/2020

Contact Information

Practice Location

101 Bodin Circle, Fairfield, CA 94535

Unlisted Fax

Mailing Location

8086 Canyon Creek Cir, Pleasanton, CA 94588-4764

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 183500000X Primary	Description Pharmacist Pharmacy Service Providers	License 78007 California