Individual provider Active NPI

Olivia Pham Mupas, PHARMD

  • Pharmacist
  • Tustin, CA
National Provider Identifier
1023390408
Registry record updated Sep 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
57644 Issued in CA
Practice address
13052 Newport Ave
Tustin, CA 92780-3535
Phone
(714) 505-6021
NPI assigned
Sep 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 57644 CA Primary

Addresses

Primary practice location

13052 Newport Ave
Tustin, CA 92780-3535

Mailing address

13052 Newport Ave
Tustin, CA 92780-3535
Phone (714) 505-6021

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

LicenseStateTypeSpecialty
57644CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315872000000",
    "number": "1023390408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13052 NEWPORT AVE",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803535",
            "telephone_number": "714-505-6021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13052 NEWPORT AVE",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803535",
            "telephone_number": "714-505-6021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUPAS",
        "first_name": "OLIVIA",
        "middle_name": "PHAM",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-13",
        "last_updated": "2011-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "57644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; 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.