Organization Active NPI

Kim Toan T DO

  • Pharmacy
  • Westminster, CA
National Provider Identifier
1972596062
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
PHY34579 Issued in CA
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

Updated by the provider on Jun 23, 2022

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
4354650001OtherMEDICARE ID
PHA345790MedicaidCA

Other names 1

  • tana pharmacy Doing business as

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.