Individual provider Active NPI

Cathy Thao Thach, PHARMD

  • Pharmacist
  • San Diego, CA
National Provider Identifier
1174963433
Registry record updated Feb 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
69676 Issued in CA
Practice address
4405 Vandever Ave
San Diego, CA 92120-3315
Phone
(619) 516-6223
NPI assigned
Jul 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 69676 CA Primary

Addresses

Primary practice location

4405 Vandever Ave
San Diego, CA 92120-3315

Mailing address

4405 Vandever Ave
San Diego, CA 92120-3315

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
69676CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1372636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486684800000",
    "number": "1174963433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 VANDEVER AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921203315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 VANDEVER AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921203315",
            "telephone_number": "619-516-6223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THACH",
        "first_name": "CATHY",
        "middle_name": "THAO",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-01",
        "last_updated": "2017-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "69676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 10, 2017; 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.