NPIMap

Organization Active NPI

Oakland Pharmacy Inc

  • Community/Retail Pharmacy
  • Oakland, CA
National Provider Identifier
1376513200
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY41907 Issued in CA
Legal business name
OAKLAND PHARMACY INC
Practice address
747 52ND Street
Oakland, CA 94609-1809
Phone
(510) 428-3166
Fax
(510) 428-3466
NPI assigned
Jan 24, 2006
Organization subpart
Yes
Parent organization
OAKLAND PHARMACY INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Authorized official

Name
Mr. Kam S Tam, PHARMD
Title
VP
Phone
(510) 813-8687

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHY41907 CA Primary

Addresses

Primary practice location

747 52ND Street
Oakland, CA 94609-1809

Mailing address

747 52ND Street
Oakland, CA 94609-1809
Phone (510) 428-3166

Other identifiers 1

IdentifierTypeStateIssuer
PHA419070MedicaidCA

Other names 1

  • Childrens Clinic Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
New Tiburcio Vasquez Health Center Pharmacy12 organizations share this tax ID, including this one
Part of
New Tiburcio Vasquez Health Center Pharmacy

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714348800000",
    "number": "1376513200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 52ND STREET",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091809",
            "telephone_number": "510-428-3166",
            "fax_number": "560-428-3466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 52ND STREET",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091809",
            "telephone_number": "510-428-3166",
            "fax_number": "510-428-3466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAKLAND PHARMACY INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OAKLAND PHARMACY INC",
        "enumeration_date": "2006-01-24",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A",
        "authorized_official_last_name": "TAM",
        "authorized_official_first_name": "KAM",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "510-813-8687",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY41907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA419070",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Childrens Clinic Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; 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.