NPIMap

Organization Active NPI

Center for Comprehensive Care & Diagnosis of Inherited Blood Disor

  • Specialty Pharmacy
  • Irvine, CA
National Provider Identifier
1194068775
Registry record updated Jul 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Specialty PharmacyTaxonomy code 3336S0011X
License
PHY503986 Issued in CA
Legal business name
CENTER FOR COMPREHENSIVE CARE & DIAGNOSIS OF INHERITED BLOOD DISOR
Practice address
18011 Sky Park Cir
Suite N
Irvine, CA 92614-6517
Phone
(949) 748-7521
Fax
(949) 748-7615
NPI assigned
Apr 1, 2013
Organization subpart
Yes
Parent organization
THE CENTER FOR COMPREHENSIVE CARE & DIAGNOSIS OF INHERITED BLOOD DISORAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 16, 2019

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

Authorized official

Name
Mary Pham, PHARM.D, CHC
Title
Coo
Phone
(949) 748-7546

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialty Pharmacy 3336S0011X PHY503986 CA Primary

Addresses

Primary practice location

18011 Sky Park Cir
Suite N
Irvine, CA 92614-6517

Mailing address

18011 Sky Park Cir
Suite N
Irvine, CA 92614-6517

Other identifiers 1

IdentifierTypeStateIssuer
GI480AOtherCAMEDICARE B

Other names 1

  • CIBD Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Center for Comprehensive Care Diagnosis of Inherited Blood Disor5 organizations share this tax ID, including this one
Part of
Center for Comprehensive Care Diagnosis of Inherited Blood Disor

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

18011 Sky Park Cir
Ste N
Irvine, CA 92614
Phone (657) 999-1404

NPI Registry JSON

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

{
    "created_epoch": "1364774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563235200000",
    "number": "1194068775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18011 SKY PARK CIR",
            "address_2": "SUITE N",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926146517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18011 SKY PARK CIR",
            "address_2": "SUITE N",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926146517",
            "telephone_number": "949-748-7521",
            "fax_number": "949-748-7615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR COMPREHENSIVE CARE & DIAGNOSIS OF INHERITED BLOOD DISOR",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE CENTER FOR COMPREHENSIVE CARE & DIAGNOSIS OF INHERITED BLOOD DISOR",
        "enumeration_date": "2013-04-01",
        "last_updated": "2019-07-16",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "949-748-7546",
        "authorized_official_credential": "PHARM.D, CHC"
    },
    "taxonomies": [
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "CA",
            "license": "PHY503986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE B",
            "identifier": "GI480A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CIBD Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CIBD Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2019; 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.