Phong Chan Lieu, PHARMD

Primary specialty

Geriatric PharmacistTaxonomy code 1835G0303X

License

10624 Issued in CA

Practice address

4363 Pacific St
Rocklin, CA 95677-2117

Phone

(916) 632-7560

NPI assigned

Jun 26, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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.

• Pacific West Pharmacy Inc

  dba Pacific West Pharmacy

  • Long Term Care Pharmacy
  • Rocklin, CA
  • NPI 1902842396
  NPD (past)

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

{
    "created_epoch": "1340668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597536000000",
    "number": "1033473962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4363 PACIFIC ST",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "956772117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4363 PACIFIC ST",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "956772117",
            "telephone_number": "916-632-7560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4025 Delridge Way, Ste 400",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "98106",
            "country_code": "US",
            "telephone_number": "877-227-8355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIEU",
        "first_name": "PHONG",
        "middle_name": "CHAN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-26",
        "last_updated": "2020-08-16",
        "certification_date": "2020-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH 60473776",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "76315",
            "primary": false
        },
        {
            "code": "1835G0303X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Geriatric",
            "state": "CA",
            "license": "10624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Sacramento",
            "affiliation": "N",
            "address_1": "4363 Pacific St",
            "city": "Rocklin",
            "state": "CA",
            "country_code": "US",
            "postal_code": "956772117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ryann Lewis, DPT
• Wade Franklin Lewis
• Richard Johnston Lichti Jr., MD
• Prabhjyot Kaur Lidhar, DDS
• Susan Liebert, MS, RD, CNSC
• Life Happens Counseling
• Life Options for Seniors
• Liftcare Mobility LLC
• Lighthouse Counseling and Family Resource Center
• Melanie Chantal Lilly

• Geriatric Pharmacist in Rocklin, CA
• Providers in Rocklin, CA by specialty
• Geriatric Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2020; 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.