Active NPI
Justin Pham Nguyen
- Pharmacist
- San Jose, CA
National Provider Identifier
1295444230
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 87160
- Practice address
- 260 International Cir
San Jose, CA 95119-1130 - Phone
- (408) 972-6335
- NPI assigned
- Nov 18, 2022
- Sex
- Male
- 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 | 87160 | CA | Primary |
Addresses
Primary practice location
260 International Cir
San Jose, CA 95119-1130
Mailing address
40328 Robin St
Fremont, CA 94538-2842
Phone (510) 754-5489
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 |
|---|---|---|---|
| 87160 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1668729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668729600000",
"number": "1295444230",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40328 ROBIN ST",
"city": "FREMONT",
"state": "CA",
"postal_code": "945382842",
"telephone_number": "510-754-5489"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "260 INTERNATIONAL CIR",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951191130",
"telephone_number": "408-972-6335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "JUSTIN",
"middle_name": "PHAM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-11-18",
"last_updated": "2022-11-18",
"certification_date": "2022-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "87160",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.