Individual provider Active NPI

Yi Yi Sun

  • Pharmacist
  • Fontana, CA
National Provider Identifier
1750975876
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
54760 Issued in CA
Practice address
16145 Sierra Lakes Pkwy
Fontana, CA 92336-1243
Phone
(909) 356-9167
NPI assigned
Mar 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 54760 CA Primary

Addresses

Primary practice location

16145 Sierra Lakes Pkwy
Fontana, CA 92336-1243

Mailing address

534 N Campus Ave
Ontario, CA 91764-3302

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
54760CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Wells Pharmacy, Inc Current Accepting new patients
Walgreen Co CurrentSince Feb 27, 2022 Accepting new patients
Walgreen Co PastSince Mar 7, 2021 Accepting new patients

Locations

16145 Sierra Lakes Pkwy
Fontana, CA 92336
Phone (909) 356-9167

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1750975876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "534 N CAMPUS AVE",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917643302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16145 SIERRA LAKES PKWY",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923361243",
            "telephone_number": "909-356-9167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUN",
        "first_name": "YI YI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-01",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "54760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.

Verify at the official NPI Registry.