Ky San, PHARM.D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

53066 Issued in CA

Practice address

5329 NE Martin Luther King Jr Blvd
Portland, OR 97211-3237

Phone

(503) 988-8264

NPI assigned

Jan 6, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1306994553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 DOLBEER ST",
            "address_2": "PHARMACY",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955014736",
            "telephone_number": "707-445-8121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5329 NE MARTIN LUTHER KING JR BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972113237",
            "telephone_number": "503-988-8264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAN",
        "first_name": "KY",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-06",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "53066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST",
            "identifier": "W598753",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashton Samuelson, DO
• Natalie San Andres, PT, DPT, OCS
• Kara Ester Flores San Joaquin, MSN, RN, MPH
• Johnnie San Nicolas
• Emily San, NP
• Sana Psychiatry LLC
• Amanda Alexes Sanabria, MA, LCAT, ATR-BC
• Marlen Sanabria, CRM
• Sanando Juntos
• Rachel Elizabeth Sanborn, MD

• Pharmacist in Portland, OR
• Providers in Portland, OR by specialty
• Pharmacist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.