NPIMap

Organization Active NPI

Garrick Shum

  • Community/Retail Pharmacy
  • Brea, CA
National Provider Identifier
1609924604
Registry record updated Aug 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY48760 Issued in CA
Legal business name
GARRICK SHUM
Practice address
385 W Central Ave
Ste E
Brea, CA 92821-3000
Phone
(714) 529-2113
Fax
(714) 529-5614
NPI assigned
Jan 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2010

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

Authorized official

Name
Garrick ShumNPI 1801326384
Title
Owner
Phone
(714) 925-2622

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHY48760 CA Primary

Addresses

Primary practice location

385 W Central Ave
Ste E
Brea, CA 92821-3000

Mailing address

385 W Central Ave
Ste E
Brea, CA 92821-3000
Phone (714) 529-2113

Other identifiers 3

IdentifierTypeStateIssuer
0505632OtherOTHER ID NUMBER
0505632OtherOTHER ID NUMBER-COMMERCIAL NUMBER
PHA454610MedicaidCA

Other names 1

  • FISHERS BREA PHARMACY Doing business as

National Provider Directory

National Provider Directory

Locations

385 W Central Ave
Ste E
Brea, CA 92821
Phone (714) 529-2113

Practitioners & affiliated clinicians

Practitioners 2

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": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282089600000",
    "number": "1609924604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 W CENTRAL AVE",
            "address_2": "STE E",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928213000",
            "telephone_number": "714-529-2113",
            "fax_number": "714-529-5614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 W CENTRAL AVE",
            "address_2": "STE E",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928213000",
            "telephone_number": "714-529-2113",
            "fax_number": "714-529-5614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARRICK SHUM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2010-08-18",
        "status": "A",
        "authorized_official_last_name": "SHUM",
        "authorized_official_first_name": "GARRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-925-2622"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY48760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "0505632",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0505632",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA454610",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FISHERS BREA PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brea, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2010; 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.