Nitiphum Chaiyakam

Primary specialty

PharmacistTaxonomy code 183500000X

License

87335 Issued in CA

Practice address

11121 Sierra Ave
Fontana, CA 92337-9310

Phone

(909) 356-9715

Fax

(909) 356-9721

NPI assigned

Aug 31, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Walgreen Co

  • Pharmacy
  • Fontana, CA
  • NPI 1689812794
  NPD
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1693440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1265218739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11121 SIERRA AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923379310",
            "telephone_number": "909-356-9715",
            "fax_number": "909-356-9721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11121 SIERRA AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923379310",
            "telephone_number": "909-356-9715",
            "fax_number": "909-356-9721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAIYAKAM",
        "first_name": "NITIPHUM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-31",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "87335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Cervantes
• Andrew C Cha, D.O
• Julie Chaejoo Chae, R.PH.
• Stephanie Hee Jun Chae, MD
• Mbebui Jane Chafeh, PTA
• Asia Juarne Chamberlain
• Karen L Chambers, PA
• Brian William Chan, MD
• Catherine Sze Wai Chan, PHARM.D.
• Francis Y Chan, PHARM.D.

• Pharmacist in Fontana, CA
• Providers in Fontana, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.

Verify at the official NPI Registry.