Active NPI
Su Jian Kong, PHARMD
- Pharmacist
- Vista, CA
National Provider Identifier
1992091847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 51746
- Practice address
- 1751 University Dr
T1040
Vista, CA 92083-7775 - Phone
- (760) 208-6000
- NPI assigned
- Jun 20, 2011
- Sex
- Female
- 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 | 51746 | CA | Primary |
Addresses
Primary practice location
1751 University Dr
T1040
Vista, CA 92083-7775
Mailing address
1751 University Dr
T1040
Vista, CA 92083-7775
Phone (760) 208-6000
Other names 1
- Su Jian Liu
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
- Doctor of Pharmacy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316131200000",
"number": "1992091847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1751 UNIVERSITY DR",
"address_2": "T1040",
"city": "VISTA",
"state": "CA",
"postal_code": "920837775",
"telephone_number": "760-208-6000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1751 UNIVERSITY DR",
"address_2": "T1040",
"city": "VISTA",
"state": "CA",
"postal_code": "920837775",
"telephone_number": "760-208-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KONG",
"first_name": "SU JIAN",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-20",
"last_updated": "2011-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "51746",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SU JIAN",
"last_name": "LIU",
"credential": "PHARMD",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Vista, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.