Individual provider Active NPI

Thuan Binh Pham, PHARM.D.

  • Pharmacist
  • Fallbrook, CA
National Provider Identifier
1255648333
Registry record updated Sep 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH42030 Issued in CA
Practice address
1221 S Mission Rd
Fallbrook, CA 92028-4005
Phone
(760) 728-6063
Fax
(760) 726-0387
NPI assigned
Sep 9, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH42030 CA Primary

Addresses

Primary practice location

1221 S Mission Rd
Fallbrook, CA 92028-4005

Mailing address

1221 Clos Duval
Bonsall, CA 92003-6114
Phone (760) 941-4094

Other identifiers 1

IdentifierTypeStateIssuer
RPH42030OtherCACALIFORNIA STATE BOARD OF PHARMACY

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

LicenseStateTypeSpecialty
RPH42030CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1283990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283990400000",
    "number": "1255648333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 CLOS DUVAL",
            "city": "BONSALL",
            "state": "CA",
            "postal_code": "920036114",
            "telephone_number": "760-941-4094",
            "fax_number": "760-728-0387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 S MISSION RD",
            "city": "FALLBROOK",
            "state": "CA",
            "postal_code": "920284005",
            "telephone_number": "760-728-6063",
            "fax_number": "760-726-0387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "THUAN",
        "middle_name": "BINH",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-09",
        "last_updated": "2010-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH42030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA STATE BOARD OF PHARMACY",
            "identifier": "RPH42030",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fallbrook, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2010; 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.