Active NPI
Ngoc Phan
- Pharmacist
- Corona, CA
National Provider Identifier
1477058477
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 52574
- Practice address
- 479 N McKinley St
Corona, CA 92879-1205 - Phone
- (951) 270-0388
- NPI assigned
- Mar 29, 2018
- 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 | 52574 | CA | Primary |
Addresses
Primary practice location
479 N McKinley St
Corona, CA 92879-1205
Mailing address
479 N McKinley St
Corona, CA 92879-1205
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 |
|---|---|---|---|
| 52574 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522281600000",
"number": "1477058477",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "479 N MCKINLEY ST",
"city": "CORONA",
"state": "CA",
"postal_code": "928791205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "479 N MCKINLEY ST",
"city": "CORONA",
"state": "CA",
"postal_code": "928791205",
"telephone_number": "951-270-0388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAN",
"first_name": "NGOC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-03-29",
"last_updated": "2018-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "CA",
"license": "52574",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.