Active NPI
Khanh Nguyen
- Pharmacist
- Santee, CA
National Provider Identifier
1699362376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 79556
- Practice address
- 9730 Mission Gorge Rd
Santee, CA 92071-3808 - Phone
- (619) 448-5110
- NPI assigned
- Dec 29, 2020
- Sex
- Male
- 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 | 79556 | CA | Primary |
Addresses
Primary practice location
9730 Mission Gorge Rd
Santee, CA 92071-3808
Mailing address
3738 31St St Apt B
San Diego, CA 92104-3725
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 79556 | Other | CA | CA STATE BOARD OF PHARMACY |
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 |
|---|---|---|---|
| 79556 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609200000000",
"number": "1699362376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3738 31ST ST APT B",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921043725"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9730 MISSION GORGE RD",
"city": "SANTEE",
"state": "CA",
"postal_code": "920713808",
"telephone_number": "619-448-5110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "KHANH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-29",
"last_updated": "2020-12-29",
"certification_date": "2020-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "79556",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CA STATE BOARD OF PHARMACY",
"identifier": "79556",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Santee, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.