Active NPI
Michael Du
- Pharmacist
- West Covina, CA
National Provider Identifier
1639446230
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 60730
- Practice address
- 1131 S Glendora Ave
West Covina, CA 91790-4955 - Phone
- (626) 338-0904
- Fax
- (626) 338-4261
- NPI assigned
- Nov 27, 2011
- Last updated
- Nov 27, 2011
- Sex
- Male
- 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 | 60730 | CA | Primary |
Addresses
Primary practice location
1131 S Glendora Ave
West Covina, CA 91790-4955
Mailing address
627 Woodbluff St
Duarte, CA 91010-1463
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 |
|---|---|---|---|
| 60730 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co. | Past | Accepting new patients |
Organizations & group practices 2
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": "1322352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322352000000",
"number": "1639446230",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "627 WOODBLUFF ST",
"city": "DUARTE",
"state": "CA",
"postal_code": "910101463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1131 S GLENDORA AVE",
"city": "WEST COVINA",
"state": "CA",
"postal_code": "917904955",
"telephone_number": "626-338-0904",
"fax_number": "626-338-4261"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DU",
"first_name": "MICHAEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-11-27",
"last_updated": "2011-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "60730",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Covina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 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.