Active NPI
Lynna Phan Davis
- Pharmacist
- San Diego, CA
National Provider Identifier
1235867524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- P11048
- Practice address
- 3350 La Jolla Village Dr
San Diego, CA 92161-1235 - Phone
- (858) 552-8585
- NPI assigned
- Aug 12, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | INT46723 | CA | |
| Pharmacist | 183500000X | P11048 | ID | Primary |
Addresses
Primary practice location
3350 La Jolla Village Dr
San Diego, CA 92161-1235
Mailing address
555 Mission Rock St Unit 629
San Francisco, CA 94158-2148
Phone (812) 629-7335
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
| License | State | Type | Specialty |
|---|---|---|---|
| P11048 | ID | MD | Pharmacist |
| INT46723 | CA | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698969600000",
"number": "1235867524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "555 MISSION ROCK ST UNIT 629",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941582148",
"telephone_number": "812-629-7335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3350 LA JOLLA VILLAGE DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921611235",
"telephone_number": "858-552-8585"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "LYNNA",
"middle_name": "PHAN",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-12",
"last_updated": "2023-11-03",
"certification_date": "2023-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": "INT46723",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ID",
"license": "P11048",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.