Provider Demographics
NPI:1144034653
Name:TRAN, AIVY (PHARMD)
Entity type:Individual
Prefix:
First Name:AIVY
Middle Name:
Last Name:TRAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 ALA MOANA BLVD APT 3709
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-4942
Mailing Address - Country:US
Mailing Address - Phone:714-204-1007
Mailing Address - Fax:
Practice Address - Street 1:600 ALA MOANA BLVD APT 3709
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-4942
Practice Address - Country:US
Practice Address - Phone:714-204-1007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH-5077-0183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist