Anaheim Pharmacy, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

ANAHEIM PHARMACY, LLC

Doing business as

Anaheim Pharmacy

Practice address

1211 W la Palma Ave Ste 102
Anaheim, CA 92801-2809

Phone

(714) 442-1141

Fax

(714) 442-1142

NPI assigned

Jun 10, 2022

Last updated

Sep 29, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jay KimNPI 1508130840

Title

Managing Member

Phone

(909) 464-0300

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• ANAHEIM PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Tax ID family

Chino Plaza Pharmacy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• JK Pharmacy Inc

  dba Chino Plaza Pharmacy

  • Long Term Care Pharmacy
  • Chino, CA
  • NPI 1548960453
  NPD tax ID
• JK Pharmacy Inc

  dba Chino Plaza Pharmacy

  • Community/Retail Pharmacy
  • Chino, CA
  • NPI 1629502554
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jay Kim, PHARMD

  • Pharmacist
  • Chino, CA
  • NPI 1508130840
  Authorized official Same address or phone
• Lin Sandar Aye, PHARMD

  • Pharmacist
  • Pomona, CA
  • NPI 1902520091
  NPD (past)

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

{
    "created_epoch": "1654819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759104000000",
    "number": "1285363556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 W LA PALMA AVE STE 102",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012809",
            "telephone_number": "714-442-1141",
            "fax_number": "714-442-1141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 W LA PALMA AVE STE 102",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012809",
            "telephone_number": "714-442-1141",
            "fax_number": "714-442-1142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANAHEIM PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-10",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "909-464-0300"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285363556",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ANAHEIM PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anaheim Memorial Medical Center
• Anaheim Orthodontics and Family Dentistry
• Anaheim Orthotics and Orthopedic Appliances
• Anaheim Palace (Harbor Heights Senior Living)
• Anaheim Pharmacy, LLC (Anaheim Pharmacy (LTC))
• Anaheim Physical Therapy and Aquatic Rehab (Magnolia Physical Therapy)
• Anaheim Plaza Pharmacy Inc (Anaheim Medical Plaza Pharmacy)
• Anaheim Point Healthcare & Wellness Centre LP (The Abby Pavilion Healthcare Center of Anaheim)
• Anaheim Point Healthcare & Wellness Centre, LP (The Abby Pavilion Healthcare Center of Anaheim)
• Anaheim Pulmonary & Critical Care Group Inc

• Community/Retail Pharmacy in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.