Individual provider Active NPI

Kyong Ha Woo

  • Pharmacist
  • Pleasanton, CA
National Provider Identifier
1215473822
Registry record updated Sep 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03136208 Issued in OH
Practice address
5918 Stoneridge Mall Rd
Pleasanton, CA 94588-3229
Phone
(937) 687-3456
NPI assigned
Jan 6, 2017
Last updated
Sep 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03136208 OH Primary

Addresses

Primary practice location

5918 Stoneridge Mall Rd
Pleasanton, CA 94588-3229

Mailing address

801 S Winchester Blvd Apt 2103
San Jose, CA 95128-2965
Phone (213) 500-5450

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

State licenses

LicenseStateTypeSpecialty
03136208OHMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Rite Aid of Ohio Inc Past 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1483660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630800000000",
    "number": "1215473822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S WINCHESTER BLVD APT 2103",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282965",
            "telephone_number": "213-500-5450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5918 STONERIDGE MALL RD",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945883229",
            "telephone_number": "937-687-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOO",
        "first_name": "KYONG HA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-06",
        "last_updated": "2021-09-05",
        "certification_date": "2021-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03136208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasanton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2021; 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.