Individual provider Active NPI

Anhdao Tran Ly, R.PH.

  • Pharmacist
  • San Diego, CA
National Provider Identifier
1962777037
Registry record updated Mar 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
48160 Issued in CA
Practice address
4605 Morena Blvd
San Diego, CA 92117-3650
Phone
(858) 581-4550
Fax
(858) 581-4424
NPI assigned
Mar 21, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 48160 CA Primary

Addresses

Primary practice location

4605 Morena Blvd
San Diego, CA 92117-3650

Mailing address

4605 Morena Blvd
San Diego, CA 92117-3650
Phone (858) 581-4550

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
48160CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1332288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332288000000",
    "number": "1962777037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4605 MORENA BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921173650",
            "telephone_number": "858-581-4550",
            "fax_number": "858-581-4424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 MORENA BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921173650",
            "telephone_number": "858-581-4550",
            "fax_number": "858-581-4424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LY",
        "first_name": "ANHDAO",
        "middle_name": "TRAN",
        "name_prefix": "Ms.",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-21",
        "last_updated": "2012-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "48160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; 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.