Organization Active NPI

Four-Fifty Sutter Pharmacy

  • Pharmacist
  • San Francisco, CA
National Provider Identifier
1114086246
Registry record updated Apr 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PHY45225 Issued in CA
Legal business name
FOUR-FIFTY SUTTER PHARMACY
Practice address
450 Sutter St
7TH Floor
San Francisco, CA 94108-4206
Phone
(415) 392-4137
Fax
(415) 951-4912
NPI assigned
Dec 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2014

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

Authorized official

Name
Elaine Chan, B.S., R.D., M.S.
Title
Owner
Phone
(415) 392-4137

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 183500000X PHY45225 CA Primary

Addresses

Primary practice location

450 Sutter St
7TH Floor
San Francisco, CA 94108-4206

Mailing address

450 Sutter St
7TH Floor
San Francisco, CA 94108-4206
Phone (415) 392-4137

Other identifiers 1

IdentifierTypeStateIssuer
PHD140970MedicaidCA

National Provider Directory

National Provider Directory

Locations

450 Sutter St
Fl 7
San Francisco, CA 94108
Phone (415) 392-4137

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396569600000",
    "number": "1114086246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 SUTTER ST",
            "address_2": "7TH FLOOR",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941084206",
            "telephone_number": "415-392-4137",
            "fax_number": "415-951-4912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 SUTTER ST",
            "address_2": "7TH FLOOR",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941084206",
            "telephone_number": "415-392-4137",
            "fax_number": "415-951-4912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR-FIFTY SUTTER PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2014-04-04",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "415-392-4137",
        "authorized_official_credential": "B.S., R.D., M.S."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "PHY45225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHD140970",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2014; 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.