Active NPI
Bao Pham
- Pharmacist
- Los Angeles, CA
National Provider Identifier
1568908226
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 68114
- Practice address
- 11818 Wilshire Blvd Ste 200
Los Angeles, CA 90025-6647 - Phone
- (310) 231-2105
- NPI assigned
- Jan 18, 2017
- Last updated
- Jan 18, 2017
- 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 | 68114 | CA | Primary |
Addresses
Primary practice location
11818 Wilshire Blvd Ste 200
Los Angeles, CA 90025-6647
Mailing address
11818 Wilshire Blvd Ste 200
Los Angeles, CA 90025-6647
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484697600000",
"number": "1568908226",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11818 WILSHIRE BLVD STE 200",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900256647"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11818 WILSHIRE BLVD STE 200",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900256647",
"telephone_number": "310-231-2105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "BAO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-01-18",
"last_updated": "2017-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "68114",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.