JINA VINH DETTMAN (NPI# 1538781505) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538781505 |
| Entity Type | Individual |
| Full Name | JINA VINH DETTMAN |
| Practice Address |
1550 W Manchester Ave Los Angeles CA 90047-5424 |
| Mailing Address |
415 Mooney Dr Apt C Monterey Park CA 91755-4124 |
| Practice Telephone | 3235653101 |
| Practice Fax Number | 3235653100 |
| Mailing Telephone | 6262026236 |
| Enumeration Date | 2020-05-13 |
| Last Update Date | 2020-05-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
RPH52670 | CA | Pharmacy Service Providers |
| Street Address |
1550 W MANCHESTER AVE |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90047-5424 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265752810 | Kenneth George Ross | Family Medicine | 1550 W Manchester Ave, Los Angeles, CA 90047-5424 | 2010-06-06 |
| 1346505294 | Neelam Pathikonda | Family Medicine | 1550 W Manchester Ave, Los Angeles, CA 90047-5424 | 2012-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063071652 | Cherae Nikia Stovall | Counselor | 1704 Manchester Boulevard, Suite 202, Los Angeles, CA 90047 | 2019-06-07 |
| 1598264053 | Dignity Health | Community/Behavioral Health | 1852 W Imperial Hwy, Los Angeles, CA 90047 | 2018-02-09 |
| 1750805222 | Brian George Martinez | Counselor | 1448 W 83rd St, Los Angeles, CA 90047 | 2017-07-27 |
| 1295266609 | Maria Amezcua | Rehabilitation Practitioner | 108 W Victoria Street, Gardena, CA 90047 | 2017-03-27 |
| 1265861140 | Ameika Porter | Counselor | 1529 West 82nd Street, Los Angeles, CA 90047 | 2013-11-01 |
| 1053747519 | Maria D Macias | Counselor | 11601 S. Western Avenue, Los Angeles, CA 90047 | 2013-09-16 |
| 1366704132 | Evelyn Carolina Hernandez | Family Medicine | 1555 West 110th Street, Los Angeles, CA 90047 | 2012-06-08 |
| 1003057142 | Sandra Patricia Trim | Licensed Vocational Nurse | 2048 W 69 St, Los Angeles, CA 90047 | 2009-03-19 |
| 1194962001 | Estuardo Ardon | Counselor | 11603 S. Western Ave., Los Angeles, CA 90047 | 2009-01-14 |
| 1174788400 | Frenda Brigette Williams | Dentist | 2015 W 81st St, Los Angeles, CA 90047 | 2008-07-25 |
| Find all providers in zip 90047 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104304765 | Alexander J Kellogg | Pharmacist | 236 S Los Angeles St Apt 334b, Los Angeles, CA 90012-3780 | 2018-08-04 |
| 1528564697 | Bonnie Lee | Pharmacist | 4640 Richelieu Ter, Los Angeles, CA 90032-3245 | 2018-04-05 |
| 1205347150 | Mee Kyoung Kim | Pharmacist | 3511 W Olympic Blvd Ste 102, Los Angeles, CA 90019-3563 | 2017-10-18 |
| 1922533231 | Edward Jai | Pharmacist | 550 S Vermont Ave Ste 903, Los Angeles, CA 90020-1912 | 2017-04-24 |
| 1346601036 | Jarrin Kean Cheng | Pharmacist | 4755 Templeton St Apt 2122, Los Angeles, CA 90032-2146 | 2016-03-09 |
| 1457745820 | Stephanie Mok | Pharmacist | 1100 N State St Rm 1b311, Los Angeles, CA 90033-5000 | 2015-03-24 |
| 1558655480 | Peyman Kharazi | Pharmacist | 1921 Glendon Ave, Apt 301, Los Angeles, CA 90025-4696 | 2011-06-08 |
| 1538489133 | Ng Patricia Lin | Pharmacist | 245 South Fetterly Avenue, Los Angeles, CA 90022 | 2010-06-04 |
| 1366772816 | Maria Kootsikas | Pharmacist | 1502 S. Crescent Heights Boulevard, Los Angeles, CA 90035-3816 | 2010-01-06 |
| 1912131210 | Dwight J Song | Pharmacist | 2018 Griffith Park Blvd, Apt #. 124, Los Angeles, CA 90039-3563 | 2009-05-14 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90047 |
Please comment or provide details below to improve the information on JINA VINH DETTMAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.