Active NPI
Samantha Pham
- Pharmacist
- Rancho Cucamonga, CA
National Provider Identifier
1295505097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 89088
- Practice address
- 7170 Day Creek Blvd
Rancho Cucamonga, CA 91739-8821 - Phone
- (909) 463-7846
- NPI assigned
- Jan 3, 2024
- 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 | 89088 | CA | Primary |
Addresses
Primary practice location
7170 Day Creek Blvd
Rancho Cucamonga, CA 91739-8821
Mailing address
2040 Furlow Dr
Redlands, CA 92374-1647
Phone (951) 442-2225
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 |
|---|---|---|---|
| 89088 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Garfield Beach CVS, L.L.C. | Past | Accepting new patients | |
| Garfield Beach CVS LLC | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1704240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704240000000",
"number": "1295505097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2040 FURLOW DR",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923741647",
"telephone_number": "951-442-2225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7170 DAY CREEK BLVD",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917398821",
"telephone_number": "909-463-7846"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "SAMANTHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-03",
"last_updated": "2024-01-03",
"certification_date": "2024-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "89088",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rancho Cucamonga, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.