Active NPI
Kim Toan T DO
- Pharmacy
- Westminster, CA
National Provider Identifier
1972596062
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- PHY34579
- Legal business name
- KIM TOAN T DO
- Practice address
- 10512 Bolsa Ave
Ste 104
Westminster, CA 92683-6727 - Phone
- (714) 554-4121
- Fax
- (714) 554-2150
- NPI assigned
- Aug 24, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Kim-Toan Thi DO, PHARMACIST
- Title
- Pharmacist Owner in Charge
- Phone
- (714) 374-1383
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | PHY34579 | CA | Primary |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
10512 Bolsa Ave
Ste 104
Westminster, CA 92683-6727
Mailing address
10512 Bolsa Ave
Westminster, CA 92683-6727
Phone (714) 554-4121
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4354650001 | Other | MEDICARE ID | |
| PHA345790 | Medicaid | CA |
Other names 1
- tana pharmacy
National Provider Directory
National Provider DirectoryLocations
10512 Bolsa Ave
Westminster, CA 92683
10512 Bolsa Ave
Ste 104
Westminster, CA 92683
Phone (714) 554-4121
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124841600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1655942400000",
"number": "1972596062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10512 BOLSA AVE",
"city": "WESTMINSTER",
"state": "CA",
"postal_code": "926836727",
"telephone_number": "714-554-4121",
"fax_number": "714-554-2150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10512 BOLSA AVE",
"address_2": "STE 104",
"city": "WESTMINSTER",
"state": "CA",
"postal_code": "926836727",
"telephone_number": "714-554-4121",
"fax_number": "714-554-2150"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KIM TOAN T DO",
"organizational_subpart": "NO",
"enumeration_date": "2005-08-24",
"last_updated": "2022-06-23",
"certification_date": "2022-06-23",
"status": "A",
"authorized_official_last_name": "DO",
"authorized_official_first_name": "KIM-TOAN",
"authorized_official_middle_name": "THI",
"authorized_official_title_or_position": "PHARMACIST OWNER IN CHARGE",
"authorized_official_telephone_number": "714-374-1383",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "PHARMACIST"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "CA",
"license": "PHY34579",
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE ID",
"identifier": "4354650001",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PHA345790",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "tana pharmacy",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "tana pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Westminster, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.