Individual provider Active NPI

John Sauen Poon, PHARM.D.

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • San Leandro, CA
National Provider Identifier
1902112030
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
63192 Issued in CA
Practice address
2500 Merced St
San Leandro, CA 94577-4201
Phone
(510) 454-2760
NPI assigned
Aug 26, 2010
Last updated
Dec 17, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 63192 CA Primary

Addresses

Primary practice location

2500 Merced St
San Leandro, CA 94577-4201

Mailing address

2500 Merced St
San Leandro, CA 94577-4201
Phone (510) 454-2760

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE)

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
63192CAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1282780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1902112030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 MERCED ST",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774201",
            "telephone_number": "510-454-2760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 MERCED ST",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774201",
            "telephone_number": "510-454-2760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POON",
        "first_name": "JOHN",
        "middle_name": "SAUEN",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-26",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "CA",
            "license": "63192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2500 Merced St",
            "city": "San Leandro",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945774201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; 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.