Individual provider Active NPI

Allen Dai, PHARMD

  • Pharmacist
  • Fairfield, CA
National Provider Identifier
1124408513
Registry record updated Jun 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
72250 Issued in CA
Practice address
300 Travis Blvd
Fairfield, CA 94533-3804
Phone
(707) 422-3460
NPI assigned
Jun 1, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 72250 CA Primary

Addresses

Primary practice location

300 Travis Blvd
Fairfield, CA 94533-3804

Mailing address

6265 Bancroft Way
San Jose, CA 95129-4003
Phone (408) 806-9967

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
72250CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Longs Drug Store California LLC Past Accepting new patients
Longs Drug Stores California LLC 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": "1433116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433116800000",
    "number": "1124408513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6265 BANCROFT WAY",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951294003",
            "telephone_number": "408-806-9967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 TRAVIS BLVD",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945333804",
            "telephone_number": "707-422-3460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAI",
        "first_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-01",
        "last_updated": "2015-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "72250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 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.

Verify at the official NPI Registry.