Active NPI
Robert Phung, PHARMD
- Pharmacist
- Surprise, AZ
National Provider Identifier
1164056065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S023738
- Practice address
- 15474 W Greenway Rd # Surprise
Surprise, AZ 85374-4348 - Phone
- (623) 584-1964
- NPI assigned
- Feb 28, 2020
- 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 | S023738 | AZ | Primary |
Addresses
Primary practice location
15474 W Greenway Rd # Surprise
Surprise, AZ 85374-4348
Mailing address
11831 164TH St
Norwalk, CA 90650-7242
Phone (626) 662-4271
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
| License | State | Type | Specialty |
|---|---|---|---|
| S023738 | AZ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582848000000",
"number": "1164056065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11831 164TH ST",
"city": "NORWALK",
"state": "CA",
"postal_code": "906507242",
"telephone_number": "626-662-4271"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15474 W GREENWAY RD # SURPRISE",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853744348",
"telephone_number": "623-584-1964"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHUNG",
"first_name": "ROBERT",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-02-28",
"last_updated": "2020-02-28",
"certification_date": "2020-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S023738",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Surprise, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.