Organization Active NPI

Yongbin Im

  • Community/Retail Pharmacy
  • San Diego, CA
National Provider Identifier
1285742718
Registry record updated Jun 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY39046 Issued in CA
Legal business name
YONGBIN IM
Practice address
3737 Moraga Ave Ste B103
San Diego, CA 92117-5352
Phone
(858) 274-1660
Fax
(858) 274-6519
NPI assigned
Aug 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2008

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

Authorized official

Name
Dr. Yongbin Im, PHARM.D.
Title
Owner
Phone
(858) 274-1660

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHY39046 CA Primary

Addresses

Primary practice location

3737 Moraga Ave Ste B103
San Diego, CA 92117-5352

Mailing address

3737 Moraga Avenue, Suite B-103
San Diego, CA 92117
Phone (858) 274-1660

Other identifiers 2

IdentifierTypeStateIssuer
0543264OtherNABP
PHA390460MedicaidCA

Other names 1

  • DE ANZA VIEW PHARMACY Doing business as

National Provider Directory

National Provider Directory

Locations

3737 Moraga Ave
Ste B103
San Diego, CA 92117
Phone (858) 799-0855

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214265600000",
    "number": "1285742718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 MORAGA AVENUE, SUITE B-103",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92117",
            "telephone_number": "858-274-1660",
            "fax_number": "858-274-6519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 MORAGA AVE STE B103",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921175352",
            "telephone_number": "858-274-1660",
            "fax_number": "858-274-6519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YONGBIN IM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2008-06-24",
        "status": "A",
        "authorized_official_last_name": "IM",
        "authorized_official_first_name": "YONGBIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "858-274-1660",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY39046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "0543264",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA390460",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DE ANZA VIEW PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2008; 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.