Active NPI
Anna Vong San, PHARMD
- Pharmacist
- Las Vegas, NV
National Provider Identifier
1679191597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 20586
- Practice address
- 3186 S Maryland Pkwy
Las Vegas, NV 89109-2317 - Phone
- (702) 961-1994
- NPI assigned
- Jul 7, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | IN05352 | NV | |
| Pharmacist | 183500000X | 20586 | NV | Primary |
Addresses
Primary practice location
3186 S Maryland Pkwy
Las Vegas, NV 89109-2317
Mailing address
3511 Del Paso Rd Ste 160
PMB 414
Sacramento, CA 95835
Other practice location 1
1800 W Charleston Blvd
Las Vegas, NV 89102-2329
Phone (702) 383-2656
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 |
|---|---|---|---|
| 20586 | NV | MD | Pharmacist |
| IN05352 | NV | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638403200000",
"number": "1679191597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3511 DEL PASO RD STE 160",
"address_2": "PMB 414",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "95835"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3186 S MARYLAND PKWY",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891092317",
"telephone_number": "702-961-1994"
}
],
"practiceLocations": [
{
"address_1": "1800 W Charleston Blvd",
"address_purpose": "LOCATION",
"city": "Las Vegas",
"state": "NV",
"postal_code": "891022329",
"country_code": "US",
"telephone_number": "702-383-2656",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SAN",
"first_name": "ANNA",
"middle_name": "VONG",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-07",
"last_updated": "2021-12-02",
"certification_date": "2021-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NV",
"license": "IN05352",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NV",
"license": "20586",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.