DR. MARK BOUNTHAVONG


Address: 3350 La Jolla Village Dr # 119, San Diego, CA 92161-0002
Phone: 8585528585

DR. MARK BOUNTHAVONG (NPI# 1720272578) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1720272578
Entity Type Individual
Full Name DR. MARK BOUNTHAVONG
Credential PHARM.D.
Practice Address 3350 La Jolla Village Dr # 119
San Diego
CA 92161-0002
Mailing Address 3950 Mahaila Ave Apt M30
San Diego
CA 92122-5742
Practice Telephone 8585528585
Practice Fax Number 8585527522
Mailing Telephone 2132685425
Enumeration Date 2007-09-04
Last Update Date 2007-09-04
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 183500000X Pharmacist RPH55969 CA Pharmacy Service Providers

Office Location

Street Address 3350 LA JOLLA VILLAGE DR # 119
City SAN DIEGO
State CA
Zip Code 92161-0002

Providers in the same location

NPI Name Taxonomy Address Enumeration
1184734956 Jessica E Harris Pharmacist 3350 La Jolla Village Dr # 119, San Diego, CA 92161-0002 2006-08-30
1144746041 Lauren Andrea Wong Pharmacist 3350 La Jolla Village Dr # 119, San Diego, CA 92161-0002 2017-08-22
1366844052 Angela Katherine Bougetz Pharmacist 3350 La Jolla Village Dr # 119, San Diego, CA 92161-0002 2014-09-24
1386045243 Lois Kim Pharmacist 3350 La Jolla Village Dr # 119, San Diego, CA 92161-0002 2014-09-10
1760816334 Nader Milad Tossoun Pharmacist 3350 La Jolla Village Dr # 119, San Diego, CA 92161-0002 2013-08-30
1275833618 Elizabeth Gramer Pharmacist 3350 La Jolla Village Dr # 119, San Diego, CA 92161-0002 2010-11-02
1518272509 Jiayi Huang Pharmacist 3350 La Jolla Village Dr # 119, San Diego, CA 92161-0002 2010-08-13

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1902315807 Laura Crocker Psychologist 3350 La Jolla Village Dr Mc 151b, San Diego, CA 92161 2017-09-22
1568849545 Deborah Falch Internal Medicine Office of Primary Care Room 3322, 3350 La Jolla Village Drive, San Diego, CA 92161 2015-04-29
1649566001 Alyan Ali Student in an Organized Health Care Education/Training Program 350 La Jolla Village Dr, Unit 118, San Diego, CA 92161 2011-06-23
1992840144 I-wei Shu Psychiatry & Neurology 3350 La Jolla Village Drive Mc 116a, San Diego, CA 92161 2007-02-21
1639252216 R Shabetai General Acute Care Hospital Vahcs 3350 La Jolla Village Dr, Cardiolgy 111a, La Jolla, CA 92161 2006-10-24
1437233624 Lee Michael Williams Marriage & Family Therapist Department of Veteran Affairs, 3350 La Jolla Village Dr, Psychology Department, San Diego, CA 92161 2006-10-24
1295824340 Pamela Anne Broder Pharmacist San Diego Va Medical Center (119), 3350 La Jolla Village Drive, San Diego, CA 92161 2006-10-12
1750484259 Michael Neil Oxman Internal Medicine Shingles Prevention Study (111f-1), Va Medical Center, 3350 La Jolla Village Drive, San Diego, CA 92161 2006-09-07
1295847358 Patricia Ellen Fornes Physical Therapist Dept. Veterens Affairs San Diego Healthcare Services, 3350 La Jolla Village Dr. Dept. Pm&r Mb 117, San Diego, CA 92161 2006-08-31
1477667087 Kathryn Victoria Frederick Louv Nurse Practitioner 3350 La Jolla Village Dr., La Jolla, CA 92161 2006-08-19
Find all providers in zip 92161

Taxonomy Information

Taxonomy Code 183500000X
Grouping Pharmacy Service Providers
Classification Pharmacist

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1518567619 Tarun Krishna Krothapalli Pharmacist 500 S Dr Ee Dunlap St Ste C, San Diego, TX 78384-3212 2020-10-28
1831702943 Hoa Thi Huynh Pharmacist 4631 Mount Longs Dr, San Diego, CA 92117-3047 2020-08-28
1750999371 Andrea D Nishimoto-macedo Pharmacist 8243 Westmore Rd, San Diego, CA 92126-2218 2020-07-20
1275141889 Amina Duh Pharmacist 6405 Mira Mesa Blvd, San Diego, CA 92121-4147 2020-07-20
1891312104 Rupangi Subhashchandra Patel Pharmacist 10892 Caminito Alvarez, San Diego, CA 92126-5808 2020-07-02
1700401403 Sun-yong Park Pharmacist 11251 Paseo Montanoso Apt 153, San Diego, CA 92127-5933 2020-06-09
1861014359 Ha Thanh Truong Pharmacist Rezcare, 3821 Calle Fortunada, San Diego, CA 92123 2020-05-07
1235760331 Farah Alaziz Pharmacist 4153 University Ave, San Diego, CA 92105-1421 2020-01-28
1356980429 Patricia Ann Walsh Pharmacist 6725 Mesa Ridge Rd Ste 230, San Diego, CA 92121-2925 2020-01-06
1003455262 Jennifer Wang Pharmacist 12037 Mil Pitrero Rd, San Diego, CA 92128-5281 2020-01-04
Find all providers in SAN DIEGO

Competitor

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City SAN DIEGO
Zip Code 92161

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Dataset Information

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.

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