Individual provider Active NPI

Sophone R Men

  • Pharmacist
  • South Gate, CA
National Provider Identifier
1508140930
Registry record updated Oct 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
46968 Issued in CA
Practice address
9830 Long Beach Blvd
South Gate, CA 90280-4153
Phone
(132) 335-7392
Fax
(132) 335-7392
NPI assigned
Oct 4, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 46968 CA Primary

Addresses

Primary practice location

9830 Long Beach Blvd
South Gate, CA 90280-4153

Mailing address

9830 Long Beach Blvd
South Gate, CA 90280-4153
Phone (323) 357-3925

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
46968CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co PastSince Mar 6, 2022 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": "1317686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317686400000",
    "number": "1508140930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9830 LONG BEACH BLVD",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902804153",
            "telephone_number": "323-357-3925",
            "fax_number": "323-357-3929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9830 LONG BEACH BLVD",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902804153",
            "telephone_number": "132-335-7392",
            "fax_number": "132-335-7392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEN",
        "first_name": "SOPHONE",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-04",
        "last_updated": "2011-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "46968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Gate, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; 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.