NPIMap

Organization Active NPI

The Center for Comprehensive Care and Diagnosis of Inherited Blood Dis

Doing business as CIBD Pharmacy

  • Community/Retail Pharmacy
  • Orange, CA
National Provider Identifier
1598067613
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY50396 Issued in CA
Legal business name
THE CENTER FOR COMPREHENSIVE CARE AND DIAGNOSIS OF INHERITED BLOOD DIS
Doing business as
CIBD Pharmacy
Practice address
701 S Parker St Ste 1400
Orange, CA 92868-4727
Phone
(949) 748-7521
Fax
(949) 748-7615
NPI assigned
Nov 22, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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

Authorized official

Name
Samantha Chan, PHARM.D.
Title
Pharmacy Manager
Phone
(657) 375-0453

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHY50396 CA Primary

Addresses

Primary practice location

701 S Parker St Ste 1400
Orange, CA 92868-4727

Mailing address

701 S Parker St Ste 1400
Orange, CA 92868-4727
Phone (949) 748-7521

Other identifiers 1

IdentifierTypeStateIssuer
2128920OtherPK

Other names 2

  • CIBD Pharmacy Doing business as
  • The Center for Comprehensive Care & Diagnosis of Inherited Blood Disor Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL csamson@c3dibd.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120810000421 CA Part B Supplier - Pharmacy 0547427288 Practice locations: Orange, CA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Center for Comprehensive Care Diagnosis of Inherited Blood Disor5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 9

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": "1290384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673913600000",
    "number": "1598067613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 S PARKER ST STE 1400",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684727",
            "telephone_number": "949-748-7521",
            "fax_number": "949-748-7615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 S PARKER ST STE 1400",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684727",
            "telephone_number": "949-748-7521",
            "fax_number": "949-748-7615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CENTER FOR COMPREHENSIVE CARE AND DIAGNOSIS OF INHERITED BLOOD DIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-22",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "657-375-0453",
        "authorized_official_credential": "PHARM.D."
    },
    "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": "PHY50396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2128920",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "csamson@c3dibd.org",
            "affiliation": "N",
            "address_1": "701 S Parker St Ste 1400",
            "city": "Orange",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928684727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "CIBD Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CIBD Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Center for Comprehensive Care & Diagnosis of Inherited Blood Disor",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.