Individual provider Active NPI

Van Le Hilburn, PHARM.D., MBA

  • Pharmacist
  • La Jolla, CA
National Provider Identifier
1144503954
Registry record updated Aug 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
61355 Issued in CA
Practice address
3855 Health Sciences Dr # 845
La Jolla, CA 92093
Phone
(858) 822-6094
NPI assigned
Sep 28, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 61355 CA Primary

Addresses

Primary practice location

3855 Health Sciences Dr # 845
La Jolla, CA 92093

Mailing address

3855 Health Sciences Dr # 845
La Jolla, CA 92093-1503
Phone (858) 822-6094

Other practice location 1

5504 Balboa Ave
San Diego, CA 92111-2704
Phone (858) 495-9155

Other identifiers 1

IdentifierTypeStateIssuer
61355OtherCACALIFORNIA BOARD OF PHARMACY

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
Master of Business Administration, Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
61355CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co. PastSince Apr 3, 2022 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": "1317168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565913600000",
    "number": "1144503954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3855 HEALTH SCIENCES DR # 845",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920931503",
            "telephone_number": "858-822-6094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3855 HEALTH SCIENCES DR # 845",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "92093",
            "telephone_number": "858-822-6094"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5504 Balboa Ave",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921112704",
            "country_code": "US",
            "telephone_number": "858-495-9155",
            "fax_number": "858-495-9142",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HILBURN",
        "first_name": "VAN",
        "middle_name": "LE",
        "name_prefix": "Mrs.",
        "credential": "PHARM.D., MBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-28",
        "last_updated": "2019-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "61355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA BOARD OF PHARMACY",
            "identifier": "61355",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2019; 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.