Individual provider Active NPI

Andy Duy Pham

  • Pharmacist
  • San Jose, CA
National Provider Identifier
1689371403
Registry record updated Feb 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
87418 Issued in CA
Practice address
1266 Fleming Ave
San Jose, CA 95127-3661
Phone
(408) 838-9410
NPI assigned
Feb 13, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 87418 CA Primary

Addresses

Primary practice location

1266 Fleming Ave
San Jose, CA 95127-3661

Mailing address

1266 Fleming Ave
San Jose, CA 95127-3661
Phone (408) 838-9410

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
87418CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1676246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1689371403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1266 FLEMING AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951273661",
            "telephone_number": "408-838-9410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1266 FLEMING AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951273661",
            "telephone_number": "408-838-9410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "ANDY",
        "middle_name": "DUY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-13",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "87418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; 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.