Active NPI
Eric Suon
- Pharmacist
- Manteca, CA
National Provider Identifier
1972140846
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 81400
- Practice address
- 1779 W Yosemite Ave
Manteca, CA 95337-5130 - Phone
- (209) 825-3616
- NPI assigned
- Dec 10, 2019
- Last updated
- Dec 17, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 | 81400 | CA | Primary |
Addresses
Primary practice location
1779 W Yosemite Ave
Manteca, CA 95337-5130
Mailing address
2022 Estep Dr
Modesto, CA 95350-2614
Phone (209) 531-4903
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 81400 | CA | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Longs Drug Stores California LLC | Past | Accepting new patients | |
| Longs Drug Store California LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1575936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639699200000",
"number": "1972140846",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2022 ESTEP DR",
"city": "MODESTO",
"state": "CA",
"postal_code": "953502614",
"telephone_number": "209-531-4903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1779 W YOSEMITE AVE",
"city": "MANTECA",
"state": "CA",
"postal_code": "953375130",
"telephone_number": "209-825-3616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUON",
"first_name": "ERIC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-12-10",
"last_updated": "2021-12-17",
"certification_date": "2021-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "CA",
"license": "81400",
"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": "2075 E Hatch Rd",
"city": "Modesto",
"state": "CA",
"country_code": "US",
"postal_code": "953515149",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Manteca, 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.