Active NPI
Eileen Han
- Pharmacist
- Moreno Valley, CA
National Provider Identifier
1295130789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 71893
- Practice address
- 12275 Perris Blvd
Moreno Valley, CA 92557-7432 - Phone
- (951) 242-8717
- NPI assigned
- Oct 27, 2014
- Last updated
- Oct 27, 2014
- Sex
- Female
- Sole proprietor
- No
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 | 71893 | CA | Primary |
Addresses
Primary practice location
12275 Perris Blvd
Moreno Valley, CA 92557-7432
Mailing address
12275 Perris Blvd
Moreno Valley, CA 92557-7432
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 |
|---|---|---|---|
| 71893 | CA | MD | Dental Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1414368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414368000000",
"number": "1295130789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12275 PERRIS BLVD",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925577432"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12275 PERRIS BLVD",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925577432",
"telephone_number": "951-242-8717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAN",
"first_name": "EILEEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-27",
"last_updated": "2014-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "71893",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moreno Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.