Active NPI
Mai-Duyen Pham
- Pharmacist
- Rialto, CA
National Provider Identifier
1548539836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH61095
- Practice address
- 2011 N Riverside Ave
Rialto, CA 92377-4601 - Phone
- (909) 820-9230
- NPI assigned
- Dec 15, 2011
- Last updated
- Dec 15, 2011
- Sex
- Female
- Sole proprietor
- No
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 | RPH61095 | CA | Primary |
Addresses
Primary practice location
2011 N Riverside Ave
Rialto, CA 92377-4601
Mailing address
957 Villa Montes Cir
Corona, CA 92879-8878
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 |
|---|---|---|---|
| RPH61095 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dca Invest LLC | Current | Accepting new patients | |
| Medphaco Inc | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co. | Past | Accepting new patients |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323907200000",
"number": "1548539836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "957 VILLA MONTES CIR",
"city": "CORONA",
"state": "CA",
"postal_code": "928798878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2011 N RIVERSIDE AVE",
"city": "RIALTO",
"state": "CA",
"postal_code": "923774601",
"telephone_number": "909-820-9230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "MAI-DUYEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-15",
"last_updated": "2011-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "RPH61095",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rialto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.