Organization Active NPI

Beach Professional Pharmacy, Inc.

Doing business as Beach Professional Pharmacy

  • Pharmacy
  • Huntington Beach, CA
National Provider Identifier
1780412544
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
BEACH PROFESSIONAL PHARMACY, INC.
Doing business as
Beach Professional Pharmacy
Practice address
17742 Beach Blvd Ste 100
Huntington Beach, CA 92647-6847
Phone
(714) 848-4447
NPI assigned
Jul 23, 2024
Last updated
Jul 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Authorized official

Name
Jasmine Hoang-Tran
Title
Ceo
Phone
(714) 848-4447

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

17742 Beach Blvd Ste 100
Huntington Beach, CA 92647-6847

Mailing address

12965 Crawford Dr
Tustin, CA 92782-1041

Other names 1

  • Beach Professional Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240910004588 CA Part B Supplier - Pharmacy 4284174715 Practice locations: Huntington Beach, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1721692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721692800000",
    "number": "1780412544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12965 CRAWFORD DR",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927821041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17742 BEACH BLVD STE 100",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926476847",
            "telephone_number": "714-848-4447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACH PROFESSIONAL PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-23",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A",
        "authorized_official_last_name": "HOANG-TRAN",
        "authorized_official_first_name": "JASMINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-848-4447"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beach Professional Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huntington Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.