Provider Demographics
NPI:1861779019
Name:TRAN, LIEM Q (PHARM D)
Entity type:Individual
Prefix:DR
First Name:LIEM
Middle Name:Q
Last Name:TRAN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2012 EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-4051
Mailing Address - Country:US
Mailing Address - Phone:408-246-1054
Mailing Address - Fax:408-246-2562
Practice Address - Street 1:2012 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-4051
Practice Address - Country:US
Practice Address - Phone:408-246-1054
Practice Address - Fax:408-246-2562
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-15
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA43421183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist