Marie Mar Phan, PHARM. D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

47496 Issued in CA

Practice address

350 N Lemon Ave
Walnut, CA 91789-2345

Phone

(909) 595-7431

Fax

(909) 595-7925

NPI assigned

Oct 25, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Vons Companies Inc

  • Community/Retail Pharmacy
  • Walnut, CA
  • NPI 1699704635
  NPD (past)
• Vons Companies Inc

  • Community/Retail Pharmacy
  • Santa Monica, CA
  • NPI 1720879919
  NPD (past)

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

{
    "created_epoch": "1287964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287964800000",
    "number": "1386944379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N LEMON AVE",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917892345",
            "telephone_number": "909-595-7431",
            "fax_number": "909-595-7925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 N LEMON AVE",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917892345",
            "telephone_number": "909-595-7431",
            "fax_number": "909-595-7925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "MARIE",
        "middle_name": "MAR",
        "name_prefix": "Dr.",
        "credential": "PHARM. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-25",
        "last_updated": "2010-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "47496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Paulin, ATC
• Saijai Peng, DDS., MSD.
• Yen Wen Peng, D.C.
• Mark Cadiente Peralta, D.P.T
• Peter C. Liu D.D.S., Inc.
• Quy-Phung Thi Phan, D.D.S
• Jennifer Pierce
• Sandra Alicia Pinon-Chavez, M.S
• Platinum Interpreting, Inc.
• Charmane Ponghirun, D.D.S.

• Pharmacist in Walnut, CA
• Providers in Walnut, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2010; 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.