Individual provider Active NPI

Alyson Kiyomi Mizuno-Kubo, PHARM.D.

  • Pharmacist
  • Downey, CA
National Provider Identifier
1639835952
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
041965 Issued in CA
Practice address
12254 Bellflower Blvd
Downey, CA 90242-2804
Phone
(562) 319-5747
NPI assigned
Nov 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 09851 NV
Pharmacist 183500000X 041965 CA Primary

Addresses

Primary practice location

12254 Bellflower Blvd
Downey, CA 90242-2804

Mailing address

1649 Tyler Dr
Fullerton, CA 92835-2146
Phone (714) 329-4794

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL EPIC Health Information Exchange (HIE)

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

LicenseStateTypeSpecialty
041965CAMDPharmacist
09851NVMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1636502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1639835952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1649 TYLER DR",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928352146",
            "telephone_number": "714-329-4794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12254 BELLFLOWER BLVD",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902422804",
            "telephone_number": "562-319-5747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZUNO-KUBO",
        "first_name": "ALYSON",
        "middle_name": "KIYOMI",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-10",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NV",
            "license": "09851",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "041965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "EPIC",
            "affiliation": "N",
            "endpointDescription": "EPIC HealthConnect",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "database",
            "address_1": "12254 Bellflower Blvd",
            "city": "Downey",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902422804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Downey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; 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.