Tydus Group

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

TYDUS GROUP

Practice address

431 N Tustin Ave Ste 431-C
Santa Ana, CA 92705-3821

Phone

(714) 707-5115

Fax

(714) 551-6822

NPI assigned

Oct 2, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Tan Pham, PHARMACYNPI 1184906307

Title

Secretary/Pic

Phone

(714) 707-5115

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• BRIGHTSIDE SPECIALTY PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare medical equipment & supply locations

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tan Phuc Pham, PHARMD

  • Pharmacist
  • Santa Ana, CA
  • NPI 1184906307
  NPD Authorized official
• Jessica Diaz

  • Pharmacist
  • Santa Ana, CA
  • NPI 1336865138
  NPD (past)
• Tori Vuthanette Ngo

  • Pharmacist
  • Santa Ana, CA
  • NPI 1629893375
  NPD (past)

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

{
    "created_epoch": "1569974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569974400000",
    "number": "1366083198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 N TUSTIN AVE STE 431-C",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053821",
            "telephone_number": "714-707-5115",
            "fax_number": "714-551-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 N TUSTIN AVE STE 431-C",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053821",
            "telephone_number": "714-707-5115",
            "fax_number": "714-551-6822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYDUS GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-02",
        "last_updated": "2019-10-02",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "TAN",
        "authorized_official_title_or_position": "SECRETARY/PIC",
        "authorized_official_telephone_number": "714-707-5115",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMACY"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY PERMIT",
            "identifier": "57437",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BRIGHTSIDE SPECIALTY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tustin ABA Services for Kids LLC
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• Tustin Optometric Center
• Valerie Tuttle, POLYSOMNOGRAPHY TECH
• Tate William Tyler
• U.S. Healthworks Medical Group, PC
• U.S. Healthworks Medical Group, PC
• U.S. Healthworks Medical Group, PC
• U.S. Healthworks Medical Group, PC

• Community/Retail Pharmacy in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.