Active NPI
Trung Phuoc Lam, PHARMD
- Pharmacist
- Azusa, CA
National Provider Identifier
1861104085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 87401
- Practice address
- 101 W Foothill Blvd
Azusa, CA 91702-2531 - Phone
- (626) 969-6669
- NPI assigned
- Dec 19, 2022
- Sex
- Male
- 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 | 87401 | CA | Primary |
Addresses
Primary practice location
101 W Foothill Blvd
Azusa, CA 91702-2531
Mailing address
1107 Sycamore Dr
Simi Valley, CA 93065-5031
Phone (805) 304-8475
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 |
|---|---|---|---|
| 87401 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Garfield Beach CVS, L.L.C. | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1671408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671408000000",
"number": "1861104085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1107 SYCAMORE DR",
"city": "SIMI VALLEY",
"state": "CA",
"postal_code": "930655031",
"telephone_number": "805-304-8475"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 W FOOTHILL BLVD",
"city": "AZUSA",
"state": "CA",
"postal_code": "917022531",
"telephone_number": "626-969-6669"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAM",
"first_name": "TRUNG",
"middle_name": "PHUOC",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-12-19",
"last_updated": "2022-12-19",
"certification_date": "2022-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "87401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Azusa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.