Katelyn Pham
Individual provider Active NPI Pharmacist · Carson, CA
NPI 1689277162 · NPPES record last updated Nov 18, 2020
Key facts
- NPI
- 1689277162
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 54093 (CA)
- Practice address
- 23806 Main St
Carson, CA 90745-5746 - Phone
- (310) 952-6640
- NPI assigned
- Nov 18, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Garfield Beach CVS, L.L.C. | Past |
Accepting new patients | |
| Garfield Beach CVS LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 54093 | CA | Yes |
Addresses
Primary practice location
23806 Main St
Carson, CA 90745-5746
Mailing address
1925 W Deerefield Rd
Santa Ana, CA 92704-7139
Other providers in Carson, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.