KMTV Inc.

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

KMTV INC.

Doing business as

Vista Pharmacy

Practice address

825 Washington Blvd.
Ste. C
Montebello, CA 90640-6179

Phone

(323) 278-0016

Fax

(323) 278-0019

NPI assigned

May 2, 2017

Last updated

Apr 14, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Minh DO

Title

Ceo/Cfo/Sec./Dir.

Phone

(408) 821-7425

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Vista Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anhthu Dam Tran, PHARMD.

  • Pharmacist
  • San Jose, CA
  • NPI 1376826305
  NPD

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

{
    "created_epoch": "1493683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649894400000",
    "number": "1427584044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 WASHINGTON BLVD.",
            "address_2": "STE. C",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906406179",
            "telephone_number": "323-278-0016",
            "fax_number": "323-278-0019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 WASHINGTON BLVD.",
            "address_2": "STE. C",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906406179",
            "telephone_number": "323-278-0016",
            "fax_number": "323-278-0019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KMTV INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-02",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A",
        "authorized_official_last_name": "DO",
        "authorized_official_first_name": "MINH",
        "authorized_official_title_or_position": "CEO/CFO/SEC./DIR.",
        "authorized_official_telephone_number": "408-821-7425"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "55542",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1427594044",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vista Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vista Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pharmacy in Montebello, CA
• Providers in Montebello, CA by specialty
• Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.