Active NPI
Quoc Cong Phan
- Pharmacist
- Long Beach, CA
National Provider Identifier
1639475999
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 52386
- Practice address
- 600 E Broadway
Long Beach, CA 90802-5124 - Phone
- (562) 624-2352
- NPI assigned
- Feb 3, 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 | 52386 | CA | Primary |
Addresses
Primary practice location
600 E Broadway
Long Beach, CA 90802-5124
Mailing address
84 Stepping Stone
Irvine, CA 92603-4206
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 |
|---|---|---|---|
| 52386 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vons Companies Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Santa Monica, CA
- NPI 1720879919
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296691200000",
"number": "1639475999",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "84 STEPPING STONE",
"city": "IRVINE",
"state": "CA",
"postal_code": "926034206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 E BROADWAY",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908025124",
"telephone_number": "562-624-2352"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAN",
"first_name": "QUOC",
"middle_name": "CONG",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-02-03",
"last_updated": "2011-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "52386",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.