Individual provider Active NPI

Julie Kimchi Pham

  • Pharmacist
  • Costa Mesa, CA
National Provider Identifier
1861761983
Registry record updated Dec 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH65296 Issued in CA
Practice address
2107 Valley Rd
Costa Mesa, CA 92627-3976
Phone
(714) 658-8489
NPI assigned
Dec 19, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH65296 CA Primary

Addresses

Primary practice location

2107 Valley Rd
Costa Mesa, CA 92627-3976

Mailing address

2107 Valley Rd
Costa Mesa, CA 92627-3976
Phone (714) 658-8489

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

LicenseStateTypeSpecialty
RPH65296CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1324252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324252800000",
    "number": "1861761983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2107 VALLEY RD",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926273976",
            "telephone_number": "714-658-8489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2107 VALLEY RD",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926273976",
            "telephone_number": "714-658-8489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "JULIE",
        "middle_name": "KIMCHI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-19",
        "last_updated": "2011-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH65296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2011; 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.