Active NPI
Soo Min Jang, PHARM.D.
- Ambulatory Care Pharmacist
- San Bernardino, CA
National Provider Identifier
1184066334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Care Pharmacist
- License
- 72535
- Practice address
- 250 S G St
San Bernardino, CA 92410 - Phone
- (909) 382-7100
- NPI assigned
- Jul 29, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | 20058256 | NY | |
| Ambulatory Care Pharmacist | 1835P2201X | 72535 | CA | Primary |
Addresses
Primary practice location
250 S G St
San Bernardino, CA 92410
Mailing address
24745 Stewart St
Loma Linda, CA 92350-1719
Other practice location 1
106 New Scotland Ave
OB 227
Albany, NY 12208-3425
Phone (518) 694-7289 ext. 289
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 |
|---|---|---|---|
| 20058256 | NY | MD | Pharmacotherapy Pharmacist |
| 72535 | CA | MD | Ambulatory Care Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526515200000",
"number": "1184066334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24745 STEWART ST",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923501719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 S G ST",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "92410",
"telephone_number": "909-382-7100"
}
],
"practiceLocations": [
{
"address_1": "106 New Scotland Ave",
"address_2": "OB 227",
"address_purpose": "LOCATION",
"city": "Albany",
"state": "NY",
"postal_code": "122083425",
"country_code": "US",
"telephone_number": "518-694-7289 x289",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JANG",
"first_name": "SOO MIN",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-07-29",
"last_updated": "2018-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "NY",
"license": "20058256",
"primary": false
},
{
"code": "1835P2201X",
"taxonomy_group": "",
"desc": "Pharmacist, Ambulatory Care",
"state": "CA",
"license": "72535",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.