Provider Demographics
NPI:1669176236
Name:TRAN, MIA M C (PHARMD)
Entity type:Individual
Prefix:
First Name:MIA
Middle Name:M C
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 1:1620 N SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-1844
Mailing Address - Country:US
Mailing Address - Phone:808-832-8265
Mailing Address - Fax:808-832-8268
Practice Address - Street 1:1620 N SCHOOL ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-1844
Practice Address - Country:US
Practice Address - Phone:808-832-8265
Practice Address - Fax:808-832-8268
Is Sole Proprietor?:No
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH-4635183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist