Active NPI
Congshan Xia, PHARMD
- Pharmacist
- Victorville, CA
National Provider Identifier
1174976765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 73820
- Practice address
- 13655 Bear Valley Rd
Victorville, CA 92392-8521 - Phone
- (760) 949-8930
- Fax
- (760) 949-9247
- NPI assigned
- Jul 19, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 | 73820 | CA | Primary |
Addresses
Primary practice location
13655 Bear Valley Rd
Victorville, CA 92392-8521
Mailing address
13655 Bear Valley Rd
Victorville, CA 92392-8521
Phone (760) 949-8930
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 |
|---|---|---|---|
| 73820 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kirin Pharmacy Inc | Current | Accepting new patients |
Organizations & group practices 1
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": "1468886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468886400000",
"number": "1174976765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13655 BEAR VALLEY RD",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923928521",
"telephone_number": "760-949-8930",
"fax_number": "760-949-9247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13655 BEAR VALLEY RD",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923928521",
"telephone_number": "760-949-8930",
"fax_number": "760-949-9247"
}
],
"practiceLocations": [],
"basic": {
"last_name": "XIA",
"first_name": "CONGSHAN",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-07-19",
"last_updated": "2016-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "73820",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Victorville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.