Active NPI
Paul Mun
- Pharmacist
- Glendale, AZ
National Provider Identifier
1083098560
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S021432
- Practice address
- 19503 N 78TH Ave
Glendale, AZ 85308-6024 - Phone
- (714) 928-7217
- NPI assigned
- Jul 15, 2015
- Sex
- Male
- 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 | S021432 | AZ | Primary |
Addresses
Primary practice location
19503 N 78TH Ave
Glendale, AZ 85308-6024
Mailing address
19503 N 78TH Ave
Glendale, AZ 85308-6024
Phone (714) 928-7217
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D6059751 | Other | CA | DRIVERS LICENSE |
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 |
|---|---|---|---|
| S021432 | AZ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438732800000",
"number": "1083098560",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19503 N 78TH AVE",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853086024",
"telephone_number": "714-928-7217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19503 N 78TH AVE",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853086024",
"telephone_number": "714-928-7217"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUN",
"first_name": "PAUL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-07-15",
"last_updated": "2015-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S021432",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVERS LICENSE",
"identifier": "D6059751",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.