Individual provider Active NPI

Tiffany Wu

  • Pharmacist
  • Rancho Palos Verdes, CA
National Provider Identifier
1669752663
Registry record updated Apr 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
72056 Issued in CA
Practice address
30019 Hawthorne Blvd
Rancho Palos Verdes, CA 90275-5434
Phone
(310) 377-6829
NPI assigned
Aug 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 72056 CA Primary

Addresses

Primary practice location

30019 Hawthorne Blvd
Rancho Palos Verdes, CA 90275-5434

Mailing address

30019 Hawthorne Blvd
Rancho Palos Verdes, CA 90275-5434

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

LicenseStateTypeSpecialty
72056CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Concourse RX Pharmacy Inc Current Accepting new patients
Ralphs Grocery Company Past Accepting new patients
Ralphs Grocery Company Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1313971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428796800000",
    "number": "1669752663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30019 HAWTHORNE BLVD",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902755434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30019 HAWTHORNE BLVD",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902755434",
            "telephone_number": "310-377-6829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WU",
        "first_name": "TIFFANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-22",
        "last_updated": "2015-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "72056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Palos Verdes, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.

Verify at the official NPI Registry.