M&I Enterprises,Inc

Primary specialty

PharmacistTaxonomy code 183500000X

License

39452 Issued in CA

Legal business name

M&I ENTERPRISES,INC

Practice address

2750 E-Washington Blvd
Suite 150
Pasadena, CA 91107

Phone

(626) 791-7595

Fax

(626) 791-3564

NPI assigned

Feb 13, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Mat(Man) Y Jung, PHARMACIST

Title

President

Phone

(626) 791-7595

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• St.Luke Professional Pharmacy Doing business as

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265574149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 E-WASHINGTON BLVD.",
            "address_2": "SUITE 150",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "91107",
            "telephone_number": "626-791-7595",
            "fax_number": "626-791-3564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 E-WASHINGTON BLVD",
            "address_2": "SUITE 150",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "91107",
            "telephone_number": "626-791-7595",
            "fax_number": "626-791-3564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M&I ENTERPRISES,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JUNG",
        "authorized_official_first_name": "MAT(MAN)",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-791-7595",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARMACIST"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "39452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP NUMBER",
            "identifier": "0581872",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "D.E.A NUMBER",
            "identifier": "BS0693095",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY PERMIT NUMBER",
            "identifier": "PHY36557",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA365570",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St.Luke Professional Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.