NPIMap

Organization Active NPI

New Oakland Pharmacy - Summit

  • Community/Retail Pharmacy
  • Oakland, CA
National Provider Identifier
1649260480
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY45270 Issued in CA
Legal business name
NEW OAKLAND PHARMACY - SUMMIT
Practice address
401 29TH St
Oakland, CA 94609-3519
Phone
(510) 839-0128
Fax
(510) 839-1990
NPI assigned
Oct 24, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Miss Kam S Tam, PHARM.D.
Title
VP
Phone
(510) 813-8687

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHY45270 CA Primary

Addresses

Primary practice location

401 29TH St
Oakland, CA 94609-3519

Mailing address

401 29TH St
Oakland, CA 94609-3519
Phone (510) 839-0128

Other identifiers 1

IdentifierTypeStateIssuer
PHA452700MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
New Tiburcio Vasquez Health Center Pharmacy12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

401 29th St
Oakland, CA 94609
Phone (510) 839-0128

NPI Registry JSON

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649260480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 29TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093519",
            "telephone_number": "510-839-0128",
            "fax_number": "510-839-1990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 29TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093519",
            "telephone_number": "510-839-0128",
            "fax_number": "510-839-1990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW OAKLAND PHARMACY - SUMMIT",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TAM",
        "authorized_official_first_name": "KAM",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "510-813-8687",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY45270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA452700",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.