Organization Active NPI

JK Pharmacy Inc

Doing business as Chino Plaza Pharmacy

  • Community/Retail Pharmacy
  • Chino, CA
National Provider Identifier
1629502554
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
55842 Issued in CA
Legal business name
JK PHARMACY INC
Doing business as
Chino Plaza Pharmacy
Practice address
5562 Philadelphia St
#110
Chino, CA 91710
Phone
(909) 464-0300
Fax
(909) 285-0991
NPI assigned
Apr 18, 2017
Last updated
Jun 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Authorized official

Name
Jay KimNPI 1508130840
Title
President
Phone
(909) 464-0300

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X NU
Community/Retail Pharmacy 3336C0003X 55842 CA Primary

Addresses

Primary practice location

5562 Philadelphia St
#110
Chino, CA 91710

Mailing address

5562 Philadelphia St
#110
Chino, CA 91710

Other identifiers 1

IdentifierTypeStateIssuer
1629502554MedicaidCA

Other names 1

  • CHINO PLAZA PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190405002110 CA Part B Supplier - Pharmacy 3173864873 Practice locations: Chino, CA
O20211203002357 CA DME Supplier - Pharmacy 3173864873 Practice locations: Chino, CA

National Provider Directory

National Provider Directory
Tax ID family
Chino Plaza Pharmacy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1492473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748908800000",
    "number": "1629502554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5562 PHILADELPHIA ST",
            "address_2": "#110",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "91710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5562 PHILADELPHIA ST",
            "address_2": "#110",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "91710",
            "telephone_number": "909-464-0300",
            "fax_number": "909-285-0991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JK PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-18",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-464-0300"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "55842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629502554",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHINO PLAZA PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CHINO PLAZA PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2025; 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.