Wayne Kan, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

30545 Issued in CA

Practice address

81893 Dr Carreon Blvd Ste 7
Indio, CA 92201-5592

Phone

(760) 347-0659

Fax

(760) 347-5972

NPI assigned

Feb 18, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• I M B Enterprises

  • Community/Retail Pharmacy
  • Indio, CA
  • NPI 1851348643
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1645142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645142400000",
    "number": "1013662865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81893 DR CARREON BLVD STE 7",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015592",
            "telephone_number": "760-347-0659",
            "fax_number": "760-347-5972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81893 DR CARREON BLVD STE 7",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015592",
            "telephone_number": "760-347-0659",
            "fax_number": "760-347-5972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAN",
        "first_name": "WAYNE",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-18",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "30545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21267",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Leo Kahm, CAARR
• Kaiser Foundation Health Plan Inc
• Ian David Kaiser, M.D.
• Michael Ming Kwan Kam, P.T.
• Vincent J Kambe, DPT
• Wan Sihk Kang, L.AC.
• Gabriel Kason
• Jane Katz-Villalobos
• James Lesley Kaufman, RADT
• David Anthony Keesee

• Pharmacist in Indio, CA
• Providers in Indio, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.