Individual provider Active NPI

Dan Pham, PHARM.D., BCACP

  • Pharmacist
  • San Jose, CA
National Provider Identifier
1174954242
Registry record updated Apr 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0012669 Issued in CT
Practice address
5855 Silver Creek Valley Rd
San Jose, CA 95138
Phone
(408) 574-9247
NPI assigned
Nov 27, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0012669 CT Primary

Addresses

Primary practice location

5855 Silver Creek Valley Rd
San Jose, CA 95138

Mailing address

5855 Silver Creek Valley Rd
San Jose, CA 95138-1059
Phone (408) 574-9110

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

LicenseStateTypeSpecialty
0012669CTMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1385510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1174954242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5855 SILVER CREEK VALLEY RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951381059",
            "telephone_number": "408-574-9110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5855 SILVER CREEK VALLEY RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95138",
            "telephone_number": "408-574-9247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "DAN",
        "name_prefix": "Dr.",
        "credential": "PHARM.D., BCACP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-27",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "0012669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; 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.