NPIMap

Individual provider Active NPI

Amy Pham Nguyen, RPH

  • Pharmacist
  • Corona, CA
National Provider Identifier
1104126291
Registry record updated Oct 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
41554 Issued in CA
Practice address
369 Magnolia Ave
Corona, CA 92879-3300
Phone
(951) 549-1910
Fax
(951) 549-1915
NPI assigned
Oct 24, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 41554 CA Primary

Addresses

Primary practice location

369 Magnolia Ave
Corona, CA 92879-3300

Mailing address

369 Magnolia Ave
Corona, CA 92879-3300
Phone (951) 549-1910

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
41554CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Vons Companies Inc Past Accepting new patients
Vons Companies Inc 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": "1287878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287878400000",
    "number": "1104126291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "369 MAGNOLIA AVE",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793300",
            "telephone_number": "951-549-1910",
            "fax_number": "951-549-1915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "369 MAGNOLIA AVE",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793300",
            "telephone_number": "951-549-1910",
            "fax_number": "951-549-1915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "AMY",
        "middle_name": "PHAM",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-24",
        "last_updated": "2010-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "41554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2010; 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.