SUBY JACOB (NPI# 1619531233) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619531233 |
| Entity Type | Individual |
| Full Name | SUBY JACOB |
| Practice Address |
11438 Kenyon Way Rancho Cucamonga CA 91701-9230 |
| Practice Telephone | 9099481065 |
| Enumeration Date | 2019-04-29 |
| Last Update Date | 2019-04-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 56266 | CA | Pharmacy Service Providers |
| Street Address |
11438 KENYON WAY |
| City | RANCHO CUCAMONGA |
| State | CA |
| Zip Code | 91701-9230 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558884882 | Alinda Joan Kniss | Speech-Language Pathologist | 8990 19 Th Street #304, Alta Loma, CA 91701 | 2017-07-19 |
| 1164739595 | Andrea G Moore-emmett | Counselor | 9330 Baseline Rd Ste 102, Rancho Cucamonga, CA 91701 | 2010-09-07 |
| 1053548644 | Suniel S. Khemlani | Family Medicine | 11398 Kenyon Way Ste J, Rancho Cucamonga, CA 91701 | 2009-06-22 |
| 1215130448 | C Mark Keen | Dentist | 9606 Baseline Rd, Alta Loma, CA 91701 | 2007-06-06 |
| 1184845711 | Andrew Liu | Specialist/Technologist | 11801 Lark Dr., Rancho Cucamonga, CA 91701 | 2007-05-01 |
| 1083741359 | Rockcreek, Inc. | Intermediate Care Facility, Mentally Retarded | 10227 Monte Vista Street, Rancho Cucamonga, CA 91701 | 2007-02-27 |
| 1194867788 | George Ji Jun Tao | Dentist | 6626 Carnelian St, Alta Loma, CA 91701 | 2007-02-12 |
| 1265590624 | Terry F Brock | Dentist | 7283 Carnelian St, Alta Loma, CA 91701 | 2006-12-05 |
| 1851461354 | Dr Tom Dental Office | Dentist | 6795 Carnelian St, Alta Loma, CA 91701 | 2006-11-09 |
| 1124127956 | Johnny S Liu | Dentist | 7168 Archibald Ave, Suite 200, Alta Loma, CA 91701 | 2006-09-21 |
| Find all providers in zip 91701 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952917338 | Priyanka Rakeshkumar Shah | Pharmacist | 9615 Evening Song Pl, Rancho Cucamonga, CA 91730-5711 | 2020-09-21 |
| 1801434576 | Wasien Arthur Phungkusol | Pharmacist | 7555 Marmande Pl, Rancho Cucamonga, CA 91730-6752 | 2019-12-12 |
| 1891332136 | Ana May Vinluan Tan | Pharmacist | 7950 Etiwanda Ave Apt 8103, Rancho Cucamonga, CA 91739-8710 | 2019-12-05 |
| 1750923595 | Jonathan Chan | Pharmacist | 7974 Haven Ave Ste 120, Rancho Cucamonga, CA 91730-3052 | 2019-10-14 |
| 1164077889 | Nancy M Yani | Pharmacist | 10431 Lemon Ave Suite G, Rancho Cucamonga, CA 91737 | 2019-08-08 |
| 1164088753 | Amy Tran | Pharmacist | 12427 Canal Dr Unit 1, Rancho Cucamonga, CA 91739-7524 | 2019-05-19 |
| 1770082141 | Rajnis Jasani | Pharmacist | 7777-b Milliken Ave, Ste 100, Rancho Cucamonga, CA 91739 | 2018-02-12 |
| 1265948780 | Adeola Philip-aimufia | Pharmacist | 13959 Dove Canyon Way, Rancho Cucamonga, CA 91739-2265 | 2017-12-20 |
| 1396260501 | Sawsan Aljazrawi | Pharmacist | 7452 Bungalow Way, Rancho Cucamonga, CA 91739-8868 | 2017-08-08 |
| 1700316924 | Quynh-mai Foord | Pharmacist | 10850 Arrow Route, Rancho Cucamonga, CA 91730 | 2017-06-20 |
| Find all providers in RANCHO CUCAMONGA | ||||
| City | RANCHO CUCAMONGA |
| Zip Code | 91701 |
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| 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.