Active NPI
Steven Vu Pham
- Pharmacist
- Sherman Oaks, CA
National Provider Identifier
1124501242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 82236
- Practice address
- 5601 Van Nuys Boulevard
Sherman Oaks, CA 91401 - Phone
- (818) 781-0569
- NPI assigned
- Sep 14, 2018
- Reactivated
- Oct 20, 2020
- 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 | 82236 | CA | Primary |
Addresses
Primary practice location
5601 Van Nuys Boulevard
Sherman Oaks, CA 91401
Mailing address
5601 Van Nuys Boulevard
Sherman Oaks, CA 91401
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 932727763 | Other | EMBLEMHEALTH |
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 |
|---|---|---|---|
| 82236 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Garfield Beach CVS LLC | Pharmacy | Past | Accepting new patients |
| Garfield Beach CVS, L.L.C. | Pharmacy | 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.
-
- Pharmacy
- Sherman Oaks, CA
- NPI 1881957900
-
- Pharmacy
- Jurupa Valley, CA
- NPI 1780573113
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603152000000",
"number": "1124501242",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5601 VAN NUYS BOULEVARD",
"city": "SHERMAN OAKS",
"state": "CA",
"postal_code": "91401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5601 VAN NUYS BOULEVARD",
"city": "SHERMAN OAKS",
"state": "CA",
"postal_code": "91401",
"telephone_number": "818-781-0569"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "STEVEN",
"middle_name": "VU",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-09-14",
"last_updated": "2020-10-20",
"certification_date": "2020-10-20",
"deactivation_date": "2019-12-12",
"reactivation_date": "2020-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "82236",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMBLEMHEALTH",
"identifier": "932727763",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Sherman Oaks, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.