Active NPI
Holly Minh Phung, PHARMD
- Pharmacist
- Orange, CA
National Provider Identifier
1851763528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 73637
- Practice address
- 480 S Main St
Orange, CA 92868-3836 - Phone
- (714) 938-1200
- NPI assigned
- Oct 21, 2015
- 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 | 73637 | CA | Primary |
Addresses
Primary practice location
480 S Main St
Orange, CA 92868-3836
Mailing address
2610 San Miguel Dr
Newport Beach, CA 92660-5437
Phone (949) 720-7044
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
| License | State | Type | Specialty |
|---|---|---|---|
| 73637 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Agoji Health Inc | Past | 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 and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Irvine, CA
- NPI 1750392262
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675036800000",
"number": "1851763528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2610 SAN MIGUEL DR",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926605437",
"telephone_number": "949-720-7044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "480 S MAIN ST",
"city": "ORANGE",
"state": "CA",
"postal_code": "928683836",
"telephone_number": "714-938-1200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHUNG",
"first_name": "HOLLY",
"middle_name": "MINH",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-10-21",
"last_updated": "2023-01-30",
"certification_date": "2023-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "73637",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.