Individual provider Active NPI

Lananh Pham Dam, PHARMD

  • Pharmacist
  • Manteca, CA
National Provider Identifier
1376735449
Registry record updated Aug 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
56451 Issued in CA
Practice address
1777 W Yosemite Ave
Manteca, CA 95337-5130
Phone
(209) 824-3616
NPI assigned
Aug 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 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 56451 CA Primary

Addresses

Primary practice location

1777 W Yosemite Ave
Manteca, CA 95337-5130

Mailing address

91 Foxwell CT
San Jose, CA 95138-1618
Phone (408) 281-4592

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
56451CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186963200000",
    "number": "1376735449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 FOXWELL CT",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951381618",
            "telephone_number": "408-281-4592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 W YOSEMITE AVE",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953375130",
            "telephone_number": "209-824-3616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAM",
        "first_name": "LANANH",
        "middle_name": "PHAM",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-13",
        "last_updated": "2007-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "56451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manteca, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.