Active NPI
Shannon Lew, PHARM D.
- Pharmacist
- Anaheim, CA
National Provider Identifier
1417164047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH 43585
- Practice address
- 3010 W Orange Ave Ste 101
Anaheim, CA 92804-3170 - Phone
- (714) 220-0719
- Fax
- (714) 220-3180
- NPI assigned
- May 16, 2007
- Last updated
- Sep 19, 2012
- Sex
- Male
- 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 | RPH 43585 | CA | Primary |
Addresses
Primary practice location
3010 W Orange Ave Ste 101
Anaheim, CA 92804-3170
Mailing address
3010 W Orange Ave Ste 101
Anaheim, CA 92804-3170
Phone (714) 220-0719
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
| License | State | Type | Specialty |
|---|---|---|---|
| RPH 43585 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medphaco Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348012800000",
"number": "1417164047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3010 W ORANGE AVE STE 101",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928043170",
"telephone_number": "714-220-0719",
"fax_number": "714-220-3180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3010 W ORANGE AVE STE 101",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928043170",
"telephone_number": "714-220-0719",
"fax_number": "714-220-3180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEW",
"first_name": "SHANNON",
"name_prefix": "Dr.",
"credential": "PHARM D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-16",
"last_updated": "2012-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "RPH 43585",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.