Individual provider Active NPI

Jaehee Nam

  • Pharmacist
  • Tustin, CA
National Provider Identifier
1316267016
Registry record updated Jun 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH41966 Issued in CA
Practice address
630 E 1St St
Tustin, CA 92780-3418
Phone
(714) 544-7274
NPI assigned
Jun 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH41966 CA Primary

Addresses

Primary practice location

630 E 1St St
Tustin, CA 92780-3418

Mailing address

17 Santa Eugenia
Irvine, CA 92606-8876

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

LicenseStateTypeSpecialty
RPH41966CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Thrifty Payless Inc Past Accepting new patients
Thrifty Payless Inc 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": "1275523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275523200000",
    "number": "1316267016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 SANTA EUGENIA",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926068876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 E 1ST ST",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803418",
            "telephone_number": "714-544-7274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAM",
        "first_name": "JAEHEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-03",
        "last_updated": "2010-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH41966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2010; 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.