Active NPI
David Pham
- Pharmacist
- Greenbrae, CA
National Provider Identifier
1245863869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 82087
- Practice address
- 330 Bon Air Ctr
Greenbrae, CA 94904-3017 - Phone
- (415) 461-9093
- NPI assigned
- Feb 21, 2020
- Last updated
- Feb 21, 2020
- Sex
- Male
- Sole proprietor
- No
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 | 82087 | CA | Primary |
Addresses
Primary practice location
330 Bon Air Ctr
Greenbrae, CA 94904-3017
Mailing address
1647 23Rd Ave
San Francisco, CA 94122-3309
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 |
|---|---|---|---|
| 82087 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Longs Drug Stores California LLC | Past | Accepting new patients | |
| Longs Drug Store California LLC | 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, 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": "1582243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582243200000",
"number": "1245863869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1647 23RD AVE",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941223309"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 BON AIR CTR",
"city": "GREENBRAE",
"state": "CA",
"postal_code": "949043017",
"telephone_number": "415-461-9093"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "DAVID",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-02-21",
"last_updated": "2020-02-21",
"certification_date": "2020-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "82087",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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- Carlos F Plata-Martinez, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.