Individual provider Active NPI

Dat Pham Le, PHARMD

  • Pharmacist
  • Martinez, CA
National Provider Identifier
1053982876
Registry record updated Jul 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
84466 Issued in CA
Practice address
150 Muir Rd
Martinez, CA 94553-4668
Phone
(916) 843-7304
NPI assigned
Jul 2, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 84466 CA Primary

Addresses

Primary practice location

150 Muir Rd
Martinez, CA 94553-4668

Mailing address

129 Deodar Dr
Pacheco, CA 94553-5539
Phone (714) 757-5290

Other practice location 1

10535 Hospital Way
Mather, CA 95655-4200
Phone (916) 843-7304

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
84466CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1625184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625184000000",
    "number": "1053982876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 DEODAR DR",
            "city": "PACHECO",
            "state": "CA",
            "postal_code": "945535539",
            "telephone_number": "714-757-5290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MUIR RD",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "945534668",
            "telephone_number": "916-843-7304"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10535 Hospital Way",
            "address_purpose": "LOCATION",
            "city": "Mather",
            "state": "CA",
            "postal_code": "956554200",
            "country_code": "US",
            "telephone_number": "916-843-7304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LE",
        "first_name": "DAT",
        "middle_name": "PHAM",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-02",
        "last_updated": "2021-07-02",
        "certification_date": "2021-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "84466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinez, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2021; 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.