Active NPI
Sarah T. Phan
- Pharmacist
- Pomona, CA
National Provider Identifier
1275885410
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 51925
- Practice address
- 80 Rio Rancho Rd
Pomona, CA 91766-4771 - Phone
- (909) 620-4077
- Fax
- (909) 620-1918
- NPI assigned
- Oct 11, 2012
- Last updated
- Oct 11, 2012
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 51925 | CA | Primary |
| Pharmacist | 183500000X | PS31800 | FL | |
| Pharmacist | 183500000X | 23501 | NJ |
Addresses
Primary practice location
80 Rio Rancho Rd
Pomona, CA 91766-4771
Mailing address
80 Rio Rancho Rd
Pomona, CA 91766-4771
Phone (909) 620-4077
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS31800 | FL | MD | Pharmacist |
| 23501 | NJ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349913600000",
"number": "1275885410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 RIO RANCHO RD",
"city": "POMONA",
"state": "CA",
"postal_code": "917664771",
"telephone_number": "909-620-4077",
"fax_number": "909-620-1918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 RIO RANCHO RD",
"city": "POMONA",
"state": "CA",
"postal_code": "917664771",
"telephone_number": "909-620-4077",
"fax_number": "909-620-1918"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAN",
"first_name": "SARAH",
"middle_name": "T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-10-11",
"last_updated": "2012-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "51925",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS31800",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "23501",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pomona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.