Provider Demographics
NPI:1972487429
Name:TRAN, MICHELLE PHUONGUYEN (PHARMD)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:PHUONGUYEN
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 1:17824 RALPHS RANCH RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-7618
Mailing Address - Country:US
Mailing Address - Phone:949-338-2011
Mailing Address - Fax:
Practice Address - Street 1:10181 SCRIPPS GATEWAY CT
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-5152
Practice Address - Country:US
Practice Address - Phone:858-790-7484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52360183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist