Active NPI
Keith Fung, PHARM.D.
- Pharmacist
- San Pedro, CA
National Provider Identifier
1639559834
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 48841
- Practice address
- 1050 N Western Ave
San Pedro, CA 90732-2428 - Phone
- (310) 833-3225
- NPI assigned
- Jun 2, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 48841 | CA | Primary |
| Pharmacist | 183500000X | 13075 | NV |
Addresses
Primary practice location
1050 N Western Ave
San Pedro, CA 90732-2428
Mailing address
2801 Sepulveda Blvd Unit 119
Torrance, CA 90505-2866
Phone (310) 328-7063
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13075 | NV | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ralphs Grocery Company | Past | Accepting new patients | |
| Ralphs Grocery Company | 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 and National Provider Directory roles.
-
- Community/Retail Pharmacy
- San Pedro, CA
- NPI 1275558876
-
- Community/Retail Pharmacy
- Pacoima, CA
- NPI 1982772711
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433203200000",
"number": "1639559834",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2801 SEPULVEDA BLVD UNIT 119",
"city": "TORRANCE",
"state": "CA",
"postal_code": "905052866",
"telephone_number": "310-328-7063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 N WESTERN AVE",
"city": "SAN PEDRO",
"state": "CA",
"postal_code": "907322428",
"telephone_number": "310-833-3225"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUNG",
"first_name": "KEITH",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-06-02",
"last_updated": "2015-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "48841",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NV",
"license": "13075",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Pedro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.