Active NPI
Shujin Pang
- Pharmacist
- Lakeville, MN
National Provider Identifier
1316539786
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 124930
- Practice address
- 17578 Dodd Blvd
Lakeville, MN 55044-3909 - Phone
- (952) 432-8770
- NPI assigned
- Feb 8, 2021
- 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 | 124930 | MN | Primary |
Addresses
Primary practice location
17578 Dodd Blvd
Lakeville, MN 55044-3909
Mailing address
5100 W 82ND St Apt 285
Minneapolis, MN 55437-1566
Phone (626) 759-1600
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 |
|---|---|---|---|
| 124930 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612742400000",
"number": "1316539786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5100 W 82ND ST APT 285",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554371566",
"telephone_number": "626-759-1600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17578 DODD BLVD",
"city": "LAKEVILLE",
"state": "MN",
"postal_code": "550443909",
"telephone_number": "952-432-8770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANG",
"first_name": "SHUJIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-08",
"last_updated": "2021-02-08",
"certification_date": "2021-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "124930",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.