Aye Win Tin Ichwan, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

74661 Issued in CA

Practice address

2701 Middlefield Rd
Palo Alto, CA 94306-2518

Phone

(650) 330-0132

NPI assigned

May 11, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Longs Drug Stores California LLC

  • Pharmacy
  • Palo Alto, CA
  • NPI 1922041763
  NPD (past)
• Longs Drug Store California LLC

  • Pharmacy
  • Kapolei, HI
  • NPI 1700565793
  NPD (past)

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578441600000",
    "number": "1972030690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12051 IMPERIAL HWY",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906503084",
            "telephone_number": "562-484-9849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 MIDDLEFIELD RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943062518",
            "telephone_number": "650-330-0132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ICHWAN",
        "first_name": "AYE",
        "middle_name": "WIN TIN",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "74661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reine-Marcelle Wendy Ibala, MPH
• Kathleen Maria Ibarra
• Sharmaine Ibasan, RN
• Badr Ibrahim, MD
• Emily Ichikawa, FNP-C
• Beau Michael Idler, MD
• Irogue Igbinosa, MD
• Ihab Andrawess DMD
• Jennifer Maurine Ikle, MD
• Irena Ilic, MD

• Pharmacist in Palo Alto, CA
• Providers in Palo Alto, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2020; 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.