Active NPI
Keumja Yang
- Pharmacist
- Montebello, CA
National Provider Identifier
1053539676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PHY45639
- Practice address
- 3001 W Beverly Blvd
Suite 102
Montebello, CA 90640-2255 - Phone
- (323) 722-0778
- Fax
- (323) 278-1121
- NPI assigned
- Apr 20, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PHY45639 | CA | Primary |
Addresses
Primary practice location
3001 W Beverly Blvd
Suite 102
Montebello, CA 90640-2255
Mailing address
828 Adelita St
Montebello, CA 90640-2505
Phone (323) 725-6458
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PHY45639 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053539676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "828 ADELITA ST",
"city": "MONTEBELLO",
"state": "CA",
"postal_code": "906402505",
"telephone_number": "323-725-6458",
"fax_number": "323-278-1121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3001 W BEVERLY BLVD",
"address_2": "SUITE 102",
"city": "MONTEBELLO",
"state": "CA",
"postal_code": "906402255",
"telephone_number": "323-722-0778",
"fax_number": "323-278-1121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YANG",
"first_name": "KEUMJA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "PHY45639",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montebello, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.