Active NPI
Yuanbo Feng
- Pharmacist
- Costa Mesa, CA
National Provider Identifier
1073053062
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 72753
- Practice address
- 1726 Superior Ave
Costa Mesa, CA 92627-3615 - Phone
- (949) 629-9714
- NPI assigned
- Feb 24, 2017
- Sex
- Male
- Sole proprietor
- No
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 | 72753 | CA | Primary |
Addresses
Primary practice location
1726 Superior Ave
Costa Mesa, CA 92627-3615
Mailing address
4547 Huddart Ave
El Monte, CA 91731-1425
Phone (626) 478-5780
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 |
|---|---|---|---|
| 72753 | CA | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487894400000",
"number": "1073053062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4547 HUDDART AVE",
"city": "EL MONTE",
"state": "CA",
"postal_code": "917311425",
"telephone_number": "626-478-5780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1726 SUPERIOR AVE",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926273615",
"telephone_number": "949-629-9714"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FENG",
"first_name": "YUANBO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-02-24",
"last_updated": "2017-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "72753",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Costa Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.