Individual provider Active NPI

Tam Hoang Nguyen

  • Community/Retail Pharmacy
  • Sacramento, CA
National Provider Identifier
1447242516
Registry record updated Jan 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHA378430 Issued in CA
Practice address
7240 E Southgate Dr
Suite # a
Sacramento, CA 95823-2627
Phone
(916) 393-5961
NPI assigned
Aug 16, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHA378430 CA Primary
Pharmacist 183500000X RPH42362 CA

Addresses

Primary practice location

7240 E Southgate Dr
Suite # a
Sacramento, CA 95823-2627

Mailing address

7240 E Southgate Dr
Suite # a
Sacramento, CA 95823-2627
Phone (916) 393-5961

Other identifiers 1

IdentifierTypeStateIssuer
PHA378430MedicaidCA

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

LicenseStateTypeSpecialty
RPH42362CAMDPharmacist
PHA378430CAMDCommunity/Retail Pharmacy

Practice roles

OrganizationSpecialtyStatusNew patients
Tam Hoang Nguyen Community/Retail Pharmacy Past Accepting new patients
Vang Pharmacy Inc Community/Retail Pharmacy Past Accepting new patients

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": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200960000000",
    "number": "1447242516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7240 E SOUTHGATE DR",
            "address_2": "SUITE # A",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958232627",
            "telephone_number": "916-393-5961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7240 E SOUTHGATE DR",
            "address_2": "SUITE # A",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958232627",
            "telephone_number": "916-393-5961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TAM",
        "middle_name": "HOANG",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2008-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHA378430",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH42362",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA378430",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2008; 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.