NPIMap

Organization Active NPI

Lien Thi Khong

  • Community/Retail Pharmacy
  • Garden Grove, CA
National Provider Identifier
1467434845
Registry record updated Dec 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY50050 Issued in CA
Legal business name
LIEN THI KHONG
Practice address
10402 Westminster Ave
Ste C
Garden Grove, CA 92843-4861
Phone
(714) 534-4133
Fax
(714) 534-4052
NPI assigned
Nov 18, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2016

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

Authorized official

Name
Susie PhanNPI 1306836358
Title
Pharmacist-in-Charge
Phone
(949) 351-9776

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHY50050 CA Primary

Addresses

Primary practice location

10402 Westminster Ave
Ste C
Garden Grove, CA 92843-4861

Mailing address

10402 Westminster Ave
Ste C
Garden Grove, CA 92843-4861
Phone (714) 534-4133

Other identifiers 1

IdentifierTypeStateIssuer
2122922OtherPK

Other names 1

  • MANNA PHARMACY Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

10402 Westminster Ave
Ste C
Garden Grove, CA 92843
Phone (714) 534-4133

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482019200000",
    "number": "1467434845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10402 WESTMINSTER AVE",
            "address_2": "STE C",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928434861",
            "telephone_number": "714-534-4133",
            "fax_number": "714-534-4052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10402 WESTMINSTER AVE",
            "address_2": "STE C",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928434861",
            "telephone_number": "714-534-4133",
            "fax_number": "714-534-4052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIEN THI KHONG",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-18",
        "last_updated": "2016-12-18",
        "status": "A",
        "authorized_official_last_name": "PHAN",
        "authorized_official_first_name": "SUSIE",
        "authorized_official_title_or_position": "PHARMACIST-IN-CHARGE",
        "authorized_official_telephone_number": "949-351-9776"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY50050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2122922",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MANNA PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2016; 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.