Active NPI
Lisa S Park-Chang, PHARMD
- Pharmacist
- San Dimas, CA
National Provider Identifier
1265718647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 49647
- Practice address
- 1086 W Arrow Hwy
San Dimas, CA 91773-2492 - Phone
- (909) 305-1352
- NPI assigned
- Oct 28, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | 49647 | CA | Primary |
Addresses
Primary practice location
1086 W Arrow Hwy
San Dimas, CA 91773-2492
Mailing address
18801 Ashley PL
Rowland Heights, CA 91748-4870
Phone (626) 964-0396
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 49647 | Other | CA | PHARMACIST |
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 |
|---|---|---|---|
| 49647 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319760000000",
"number": "1265718647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18801 ASHLEY PL",
"city": "ROWLAND HEIGHTS",
"state": "CA",
"postal_code": "917484870",
"telephone_number": "626-964-0396"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1086 W ARROW HWY",
"city": "SAN DIMAS",
"state": "CA",
"postal_code": "917732492",
"telephone_number": "909-305-1352"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK-CHANG",
"first_name": "LISA",
"middle_name": "S",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-10-28",
"last_updated": "2011-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "49647",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST",
"identifier": "49647",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Dimas, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.