Active NPI
Kaitlyn Tam
- Pharmacist
- Pomona, CA
National Provider Identifier
1427604909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 61207
- Practice address
- 1485 S Garey Ave
Pomona, CA 91766-4414 - Phone
- (909) 623-0562
- NPI assigned
- Aug 12, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 | 61207 | CA | Primary |
Addresses
Primary practice location
1485 S Garey Ave
Pomona, CA 91766-4414
Mailing address
1485 S Garey Ave
Pomona, CA 91766-4414
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 |
|---|---|---|---|
| 61207 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Garfield Beach CVS, L.L.C. | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565568000000",
"number": "1427604909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1485 S GAREY AVE",
"city": "POMONA",
"state": "CA",
"postal_code": "917664414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1485 S GAREY AVE",
"city": "POMONA",
"state": "CA",
"postal_code": "917664414",
"telephone_number": "909-623-0562"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAM",
"first_name": "KAITLYN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-12",
"last_updated": "2019-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "61207",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pomona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.