Active NPI
Johnny Thai
- Pharmacist
- San Dimas, CA
National Provider Identifier
1306122817
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 66097
- Practice address
- 1086 W Arrow Hwy
San Dimas, CA 91773-2492 - Phone
- (909) 305-1352
- NPI assigned
- Oct 27, 2011
- Last updated
- Jul 30, 2012
- 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 | 66097 | CA | Primary |
Addresses
Primary practice location
1086 W Arrow Hwy
San Dimas, CA 91773-2492
Mailing address
1086 W Arrow Hwy
San Dimas, CA 91773-2492
Phone (909) 305-1352
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 |
|---|---|---|---|
| 66097 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319673600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343606400000",
"number": "1306122817",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1086 W ARROW HWY",
"city": "SAN DIMAS",
"state": "CA",
"postal_code": "917732492",
"telephone_number": "909-305-1352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1086 W ARROW HWY",
"city": "SAN DIMAS",
"state": "CA",
"postal_code": "917732492",
"telephone_number": "909-305-1352"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THAI",
"first_name": "JOHNNY",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-10-27",
"last_updated": "2012-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "66097",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Dimas, CA
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.