Individual provider Active NPI

Sophana Chan Chhim

  • Pharmacist
  • Sacramento, CA
National Provider Identifier
1700135878
Registry record updated Sep 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
68032 Issued in CA
Practice address
1919 Fulton Ave
Sacramento, CA 95825-1905
Phone
(916) 483-5141
NPI assigned
Sep 5, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 68032 CA Primary

Addresses

Primary practice location

1919 Fulton Ave
Sacramento, CA 95825-1905

Mailing address

1919 Fulton Ave
Sacramento, CA 95825-1905

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
68032CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346803200000",
    "number": "1700135878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 FULTON AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958251905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 FULTON AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958251905",
            "telephone_number": "916-483-5141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHHIM",
        "first_name": "SOPHANA",
        "middle_name": "CHAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-05",
        "last_updated": "2012-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "68032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2012; 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.