Individual provider Active NPI

Haeseon S Eom, PHARM.D.

  • Pharmacist
  • Martinez, CA
National Provider Identifier
1376641043
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH43077 Issued in CA
Practice address
150 Muir Road
Martinez, CA 94553
Phone
(925) 370-4776
Fax
(925) 370-4724
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH43077 CA Primary

Addresses

Primary practice location

150 Muir Road
Martinez, CA 94553

Mailing address

305 Lorraine Blvd
San Leandro, CA 94577
Phone (925) 370-4776

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

State licenses

LicenseStateTypeSpecialty
RPH43077CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376641043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 LORRAINE BLVD",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "94577",
            "telephone_number": "925-370-4776",
            "fax_number": "925-370-4724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MUIR ROAD",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "94553",
            "telephone_number": "925-370-4776",
            "fax_number": "925-370-4724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EOM",
        "first_name": "HAESEON",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH43077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinez, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.