Active NPI
Loan Ngoc Pham
- Pharmacist
- Leesburg, VA
National Provider Identifier
1790906220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202011441
- Practice address
- 1079 Edwards Ferry Rd NE
Leesburg, VA 20176 - Phone
- (703) 554-6021
- Fax
- (703) 554-6024
- NPI assigned
- May 1, 2007
- Last updated
- Oct 14, 2008
- Sex
- Female
- 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 | 0202011441 | VA | Primary |
Addresses
Primary practice location
1079 Edwards Ferry Rd NE
Leesburg, VA 20176
Mailing address
43332 Vestals Place
Leesburg, VA 20176
Phone (571) 333-3979
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 |
|---|---|---|---|
| 0202011441 | VA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1223942400000",
"number": "1790906220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "43332 VESTALS PLACE",
"city": "LEESBURG",
"state": "VA",
"postal_code": "20176",
"telephone_number": "571-333-3979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1079 EDWARDS FERRY RD NE",
"city": "LEESBURG",
"state": "VA",
"postal_code": "20176",
"telephone_number": "703-554-6021",
"fax_number": "703-554-6024"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "LOAN",
"middle_name": "NGOC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-01",
"last_updated": "2008-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202011441",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Leesburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.