Active NPI
Olivia Jiun Phung, PHARMD
- Pharmacist
- Pomona, CA
National Provider Identifier
1023318839
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 604053
- Practice address
- 309 E 2ND St
Pomona, CA 91766-1854 - Phone
- (909) 469-8205
- NPI assigned
- Oct 26, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 604053 | CA | Primary |
| Pharmacist | 183500000X | PCT.0011000 | CT |
Addresses
Primary practice location
309 E 2ND St
Pomona, CA 91766-1854
Mailing address
309 E 2ND St
Pomona, CA 91766-1854
Phone (909) 469-8205
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 604053 | CA | MD | Pharmacist |
| PCT.0011000 | CT | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288051200000",
"number": "1023318839",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "309 E 2ND ST",
"city": "POMONA",
"state": "CA",
"postal_code": "917661854",
"telephone_number": "909-469-8205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "309 E 2ND ST",
"city": "POMONA",
"state": "CA",
"postal_code": "917661854",
"telephone_number": "909-469-8205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHUNG",
"first_name": "OLIVIA",
"middle_name": "JIUN",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-10-26",
"last_updated": "2010-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "604053",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "PCT.0011000",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pomona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.