Individual provider Active NPI

Phung Khanh Le

  • Pharmacist
  • Fullerton, CA
National Provider Identifier
1992285456
Registry record updated Aug 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
69305 Issued in CA
Practice address
2200 N Harbor Blvd
Fullerton, CA 92835-2605
Phone
(714) 446-9421
NPI assigned
Aug 15, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 69305 CA Primary

Addresses

Primary practice location

2200 N Harbor Blvd
Fullerton, CA 92835-2605

Mailing address

8192 Bellhaven St
La Palma, CA 90623-1911
Phone (714) 260-2213

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

LicenseStateTypeSpecialty
69305CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1534291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1992285456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8192 BELLHAVEN ST",
            "city": "LA PALMA",
            "state": "CA",
            "postal_code": "906231911",
            "telephone_number": "714-260-2213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 N HARBOR BLVD",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928352605",
            "telephone_number": "714-446-9421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "PHUNG",
        "middle_name": "KHANH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-15",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "69305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; 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.