Active NPI
Yongbin Im
- Community/Retail Pharmacy
- San Diego, CA
National Provider Identifier
1285742718
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PHY39046
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0543264 | Other | NABP | |
| PHA390460 | Medicaid | CA |
Other names 1
- DE ANZA VIEW PHARMACY
National Provider Directory
National Provider DirectoryLocations
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.