Active NPI
Berlinda Phommalayhane
- Pharmacist
- Rancho Cucamonga, CA
National Provider Identifier
1386746196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PHY47175
- Practice address
- 9057 Arrow Rte
Suite 170
Rancho Cucamonga, CA 91730-4452 - Phone
- (909) 466-6701
- Fax
- (909) 476-7747
- NPI assigned
- Sep 2, 2006
- Sex
- Female
- Sole proprietor
- No
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 | PHY47175 | CA | Primary |
Addresses
Primary practice location
9057 Arrow Rte
Suite 170
Rancho Cucamonga, CA 91730-4452
Mailing address
9057 Arrow Rte
Suite 170
Rancho Cucamonga, CA 91730-4452
Phone (909) 466-6701
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PHY47175 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202947200000",
"number": "1386746196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9057 ARROW RTE",
"address_2": "SUITE 170",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917304452",
"telephone_number": "909-466-6701",
"fax_number": "909-476-7747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9057 ARROW RTE",
"address_2": "SUITE 170",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917304452",
"telephone_number": "909-466-6701",
"fax_number": "909-476-7747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHOMMALAYHANE",
"first_name": "BERLINDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-02",
"last_updated": "2008-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "PHY47175",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rancho Cucamonga, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.