Organization Active NPI

Dansam LLC

  • Community/Retail Pharmacy
  • San Diego, CA
National Provider Identifier
1144066358
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
DANSAM LLC
Doing business as
Pacific Beach Pharmacy
Practice address
1721 Garnet Ave
San Diego, CA 92109-3351
Phone
(858) 900-9877
Fax
(858) 203-3707
NPI assigned
Jul 8, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Authorized official

Name
Dr. Daniel LeeNPI 1427716091
Title
Ceo
Phone
(858) 900-9877

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

1721 Garnet Ave
San Diego, CA 92109-3351

Mailing address

1721 Garnet Ave
San Diego, CA 92109-3351
Phone (858) 900-9877

Other names 1

  • Pacific Beach Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250626004117 CA Part B Supplier - Pharmacy 9931612678 Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Locations

1721 Garnet Ave
San Diego, CA 92109
Phone (858) 900-9877

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": "1720396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746489600000",
    "number": "1144066358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 GARNET AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921093351",
            "telephone_number": "858-900-9877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 GARNET AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921093351",
            "telephone_number": "858-900-9877",
            "fax_number": "858-203-3707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANSAM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-08",
        "last_updated": "2025-05-06",
        "certification_date": "2025-04-25",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "858-900-9877",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Beach Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pacific Beach Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.