Active NPI
Hoang Pham
- Pharmacist
- Jackson, CA
National Provider Identifier
1316355837
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 70151
- Practice address
- 10355 Wicklow Way
Jackson, CA 95642-9324 - Phone
- (209) 223-5193
- NPI assigned
- Jul 28, 2014
- Last updated
- Jul 28, 2014
- 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 | 70151 | CA | Primary |
Addresses
Primary practice location
10355 Wicklow Way
Jackson, CA 95642-9324
Mailing address
3360 Onslow Way
San Jose, CA 95132-3028
Phone (408) 802-8289
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 |
|---|---|---|---|
| 70151 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walmart Inc. | Past | Accepting new patients | |
| Walmart 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406505600000",
"number": "1316355837",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3360 ONSLOW WAY",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951323028",
"telephone_number": "408-802-8289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10355 WICKLOW WAY",
"city": "JACKSON",
"state": "CA",
"postal_code": "956429324",
"telephone_number": "209-223-5193"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "HOANG",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-07-28",
"last_updated": "2014-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "70151",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.