Active NPI
Wayne Chan, PHARM D
- Pharmacist
- San Jose, CA
National Provider Identifier
1326348483
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 51696
- Practice address
- 5760 Cottle Rd
San Jose, CA 95123-3624 - Phone
- (408) 362-9623
- NPI assigned
- Oct 22, 2010
- Last updated
- Sep 5, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 | 51696 | CA | Primary |
Addresses
Primary practice location
5760 Cottle Rd
San Jose, CA 95123-3624
Mailing address
2972 Stallion Way
San Jose, CA 95121-1782
Phone (408) 710-5302
Other practice location 1
3970 Rivermark Plz
Safeway Pharmacy
Santa Clara, CA 95054-4155
Phone (408) 855-0985
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
- Credentials
- Doctor of Pharmacy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Safeway Inc | Past | Accepting new patients | |
| Safeway Inc | Past | Accepting new patients | |
| Safeway Inc | Past | Accepting new patients |
Organizations & group practices 3
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": "1287705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567641600000",
"number": "1326348483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2972 STALLION WAY",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951211782",
"telephone_number": "408-710-5302",
"fax_number": "408-855-0989"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5760 COTTLE RD",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951233624",
"telephone_number": "408-362-9623"
}
],
"practiceLocations": [
{
"address_1": "3970 Rivermark Plz",
"address_2": "Safeway Pharmacy",
"address_purpose": "LOCATION",
"city": "Santa Clara",
"state": "CA",
"postal_code": "950544155",
"country_code": "US",
"telephone_number": "408-855-0985",
"fax_number": "408-855-0989",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHAN",
"first_name": "WAYNE",
"name_prefix": "Mr.",
"credential": "PHARM D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-10-22",
"last_updated": "2019-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "51696",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.