Active NPI
Kenny D. Han, PHARMD
- Pharmacist
- Rancho Cordova, CA
National Provider Identifier
1134528755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 70872
- Practice address
- 10635 Folsom Blvd
Rancho Cordova, CA 95670-4828 - Phone
- (916) 364-4944
- NPI assigned
- Aug 19, 2014
- Sex
- Male
- Sole proprietor
- No
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 | 70872 | CA | Primary |
Addresses
Primary practice location
10635 Folsom Blvd
Rancho Cordova, CA 95670-4828
Mailing address
5002 Ocean LN
Elk Grove, CA 95757-2543
Phone (626) 588-8368
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Safeway Inc | Past | Accepting new patients | |
| Safeway 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.
-
- Community/Retail Pharmacy
- Rancho Cordova, CA
- NPI 1033148069
-
- Community/Retail Pharmacy
- Queen Creek, AZ
- NPI 1730040973
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408406400000",
"number": "1134528755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5002 OCEAN LN",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "957572543",
"telephone_number": "626-588-8368"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10635 FOLSOM BLVD",
"city": "RANCHO CORDOVA",
"state": "CA",
"postal_code": "956704828",
"telephone_number": "916-364-4944"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAN",
"first_name": "KENNY",
"middle_name": "D.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-08-19",
"last_updated": "2014-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "70872",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rancho Cordova, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.