Individual provider Active NPI

Lily Duong, PHARMD

  • Pharmacist
  • Lodi, CA
National Provider Identifier
1437402138
Registry record updated Mar 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
68046 Issued in CA
Practice address
2449 W Kettleman LN
Lodi, CA 95242
Phone
(209) 367-7882
NPI assigned
Oct 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 68046 CA Primary

Addresses

Primary practice location

2449 W Kettleman LN
Lodi, CA 95242

Mailing address

2449 W Kettleman LN
Lodi, CA 95242-4124
Phone (209) 367-7882

Other practice location 1

14840 Highway 4
Discovery Bay, CA 94505-2236
Phone (925) 626-6011

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

LicenseStateTypeSpecialty
68046CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Safeway Inc Past Accepting new patients
Safeway Inc Past Accepting new patients
Safeway Inc Past Accepting new patients

Organizations & group practices 3

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": "1350518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553212800000",
    "number": "1437402138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2449 W KETTLEMAN LN",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952424124",
            "telephone_number": "209-367-7882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2449 W KETTLEMAN LN",
            "city": "LODI",
            "state": "CA",
            "postal_code": "95242",
            "telephone_number": "209-367-7882"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14840 Highway 4",
            "address_purpose": "LOCATION",
            "city": "Discovery Bay",
            "state": "CA",
            "postal_code": "945052236",
            "country_code": "US",
            "telephone_number": "925-626-6011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUONG",
        "first_name": "LILY",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-18",
        "last_updated": "2019-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "68046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lodi, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.

Verify at the official NPI Registry.