Active NPI
Soo Ah Kwon
- Pharmacist
- Mountain View, CA
National Provider Identifier
1649932112
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 87607
- Practice address
- 555 Showers Dr
Mountain View, CA 94040-4795 - Phone
- (650) 965-0129
- NPI assigned
- Oct 12, 2021
- Sex
- Female
- Sole proprietor
- No
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 | 87607 | CA | Primary |
Addresses
Primary practice location
555 Showers Dr
Mountain View, CA 94040-4795
Mailing address
1822 Edgewood Dr
Palo Alto, CA 94303-3015
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 |
|---|---|---|---|
| 87607 | CA | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Apex Pharmacy Plus Inc | Past | Accepting new patients | |
| Garfield Beach CVS, L.L.C. | 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
- Garden Grove, CA
- NPI 1487208534
-
- Pharmacy
- Jurupa Valley, CA
- NPI 1780573113
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724457600000",
"number": "1649932112",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1822 EDGEWOOD DR",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943033015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 SHOWERS DR",
"city": "MOUNTAIN VIEW",
"state": "CA",
"postal_code": "940404795",
"telephone_number": "650-965-0129"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KWON",
"first_name": "SOO AH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-12",
"last_updated": "2024-08-24",
"certification_date": "2024-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "87607",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mountain View, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.