Individual provider Active NPI

Cynthia Mayi Chan, PHARMD

  • Pharmacist
  • Los Angeles, CA
National Provider Identifier
1023522810
Registry record updated Dec 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
77919 Issued in CA
Practice address
1611 E Cesar E Chavez Ave
Los Angeles, CA 90033-2411
Phone
(323) 222-0736
NPI assigned
Dec 1, 2017
Last updated
Dec 1, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 77919 CA Primary

Addresses

Primary practice location

1611 E Cesar E Chavez Ave
Los Angeles, CA 90033-2411

Mailing address

221 S Olive Ave Apt 8
Alhambra, CA 91801-3241
Phone (917) 330-0351

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
77919CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Boyle Heights RX Inc Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1512086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512086400000",
    "number": "1023522810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 S OLIVE AVE APT 8",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918013241",
            "telephone_number": "917-330-0351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 E CESAR E CHAVEZ AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900332411",
            "telephone_number": "323-222-0736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "CYNTHIA",
        "middle_name": "MAYI",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-01",
        "last_updated": "2017-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "77919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2017; 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.