Individual provider Active NPI

Steven A Kong, PHARM. D.

  • Pharmacist
  • San Quentin, CA
National Provider Identifier
1801166053
Registry record updated Sep 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH46304 Issued in CA
Practice address
1 Main St
San Quentin, CA 94964-1000
Phone
(415) 454-1460
NPI assigned
Jan 5, 2012
Last updated
Sep 21, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH46304 CA Primary

Addresses

Primary practice location

1 Main St
San Quentin, CA 94964-1000

Mailing address

PO Box 77
San Quentin, CA 94964-0077
Phone (650) 755-6132

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RPH46304CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Corrections and Rehabilitation-Headquarters PastSince Mar 22, 2020 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1325721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474416000000",
    "number": "1801166053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 77",
            "city": "SAN QUENTIN",
            "state": "CA",
            "postal_code": "949640077",
            "telephone_number": "650-755-6132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MAIN ST",
            "city": "SAN QUENTIN",
            "state": "CA",
            "postal_code": "949641000",
            "telephone_number": "415-454-1460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONG",
        "first_name": "STEVEN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PHARM. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-05",
        "last_updated": "2016-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH46304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Quentin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2016; 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.