Active NPI
Stacy Pham, PHARM.D
- Pharmacist
- Long Beach, CA
National Provider Identifier
1245509124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 58676
- Practice address
- 3570 Atlantic Ave
Long Beach, CA 90807-4516 - Phone
- (562) 424-3963
- NPI assigned
- Dec 21, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 58676 | CA | Primary |
Addresses
Primary practice location
3570 Atlantic Ave
Long Beach, CA 90807-4516
Mailing address
10212 Bellehurst Ave
Westminster, CA 92683-5779
Phone (714) 585-8534
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 |
|---|---|---|---|
| 58676 | CA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1324425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324425600000",
"number": "1245509124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10212 BELLEHURST AVE",
"city": "WESTMINSTER",
"state": "CA",
"postal_code": "926835779",
"telephone_number": "714-585-8534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3570 ATLANTIC AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908074516",
"telephone_number": "562-424-3963"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "STACY",
"credential": "PHARM.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-12-21",
"last_updated": "2011-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "58676",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.