Individual provider Active NPI

Nguyen D Dao, PHARM.D.

  • Pharmacist
  • San Bernardino, CA
National Provider Identifier
1417460247
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
48105 Issued in CA
Practice address
1033 N Waterman Ave Ste C
San Bernardino, CA 92410-3808
Phone
(909) 884-2739
Fax
(909) 885-8880
NPI assigned
Nov 15, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 48105 CA Primary

Addresses

Primary practice location

1033 N Waterman Ave Ste C
San Bernardino, CA 92410-3808

Mailing address

1033 N Waterman Ave Ste C
San Bernardino, CA 92410-3808
Phone (909) 884-2739

Other practice location 1

400 N Pepper Ave
Colton, CA 92324-1801
Phone (909) 580-0016

Other identifiers 1

IdentifierTypeStateIssuer
48105OtherCAPHARMACIST

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

Practice roles

OrganizationSpecialtyStatusNew patients
Inland Empire Pharmacy Services Inc Current Accepting new patients
Family Pharmacy, Inc. Current Accepting new patients

Locations

1033 N Waterman Ave
Ste C
Sn Bernrdno, CA 92410
Phone (909) 884-2739

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1510704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1417460247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 N WATERMAN AVE STE C",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924103808",
            "telephone_number": "909-884-2739",
            "fax_number": "909-885-8880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 N WATERMAN AVE STE C",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924103808",
            "telephone_number": "909-884-2739",
            "fax_number": "909-885-8880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 N Pepper Ave",
            "address_purpose": "LOCATION",
            "city": "Colton",
            "state": "CA",
            "postal_code": "923241801",
            "country_code": "US",
            "telephone_number": "909-580-0016",
            "fax_number": "909-580-1033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAO",
        "first_name": "NGUYEN",
        "middle_name": "D",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-11-15",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "48105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST",
            "identifier": "48105",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.