Active NPI
Anhao Sam, PHARMD
- Pharmacist
- Modesto, CA
National Provider Identifier
1255916581
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH84301
- Practice address
- 730 17TH St
Modesto, CA 95354-1209 - Phone
- (209) 248-7519
- NPI assigned
- Mar 17, 2021
- 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 | RPH84301 | CA | Primary |
Addresses
Primary practice location
730 17TH St
Modesto, CA 95354-1209
Mailing address
9940 Diamonte Way
Sacramento, CA 95829-8147
Phone (760) 519-9671
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 |
|---|---|---|---|
| RPH84301 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615939200000",
"number": "1255916581",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9940 DIAMONTE WAY",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958298147",
"telephone_number": "760-519-9671"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "730 17TH ST",
"city": "MODESTO",
"state": "CA",
"postal_code": "953541209",
"telephone_number": "209-248-7519"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAM",
"first_name": "ANHAO",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-03-17",
"last_updated": "2021-03-17",
"certification_date": "2021-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "RPH84301",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.