Individual provider Active NPI

Robert Yam

  • Pharmacist
  • Stockton, CA
National Provider Identifier
1063798650
Registry record updated Oct 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
65731 Issued in CA
Practice address
10424 Trinity Pkwy
Target Pharmacy Store Number (T-1862)
Stockton, CA 95219-7225
Phone
(209) 235-0251
NPI assigned
Oct 26, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 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 65731 CA Primary

Addresses

Primary practice location

10424 Trinity Pkwy
Target Pharmacy Store Number (T-1862)
Stockton, CA 95219-7225

Mailing address

10424 Trinity Pkwy
Target Pharmacy Store Number (T-1862)
Stockton, CA 95219-7225
Phone (209) 235-0251

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

LicenseStateTypeSpecialty
65731CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1319587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319587200000",
    "number": "1063798650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10424 TRINITY PKWY",
            "address_2": "TARGET PHARMACY STORE NUMBER (T-1862)",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952197225",
            "telephone_number": "209-235-0251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10424 TRINITY PKWY",
            "address_2": "TARGET PHARMACY STORE NUMBER (T-1862)",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952197225",
            "telephone_number": "209-235-0251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAM",
        "first_name": "ROBERT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-26",
        "last_updated": "2011-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "65731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.