Organization Active NPI

Helen L. Tan, RPH, Inc

Doing business as Botica San Jose

  • Community/Retail Pharmacy
  • Los Angeles, CA
National Provider Identifier
1184766750
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
54490 Issued in CA
Legal business name
HELEN L. TAN, RPH, INC
Doing business as
Botica San Jose
Practice address
326 N Vermont Ave Ste B
Los Angeles, CA 90004-3511
Phone
(323) 668-1766
Fax
(323) 668-1348
NPI assigned
Feb 12, 2007
Last updated
Aug 23, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Authorized official

Name
Ms. Helen L Tan, RPHNPI 1669927422
Title
President - Owner
Phone
(323) 668-1766

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 54490 CA Primary

Addresses

Primary practice location

326 N Vermont Ave Ste B
Los Angeles, CA 90004-3511

Mailing address

326 N Vermont Ave Ste B
Los Angeles, CA 90004-3511
Phone (323) 668-1766

Other identifiers 1

IdentifierTypeStateIssuer
PHA366250MedicaidCA

Other names 1

  • Botica San Jose Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201222001932 CA Part B Supplier - Mass Immunization (Roster Biller Only) 5799024691 Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

1417 N Vermont Ave
Los Angeles, CA 90027
Phone (323) 668-1766

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692748800000",
    "number": "1184766750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 N VERMONT AVE STE B",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900043511",
            "telephone_number": "323-668-1766",
            "fax_number": "323-668-1348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 N VERMONT AVE STE B",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900043511",
            "telephone_number": "323-668-1766",
            "fax_number": "323-668-1348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HELEN L. TAN, RPH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2023-08-23",
        "certification_date": "2023-06-23",
        "status": "A",
        "authorized_official_last_name": "TAN",
        "authorized_official_first_name": "HELEN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT - OWNER",
        "authorized_official_telephone_number": "323-668-1766",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "54490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA366250",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Botica San Jose",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Botica San Jose",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.