KELLY PHAM (NPI# 1932696457) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932696457 |
| Entity Type | Individual |
| Full Name | KELLY PHAM |
| Credential | PHARMD |
| Practice Address |
3151 University Ave San Diego CA 92104-2039 |
| Mailing Address |
2005 Burton St Apt 12 San Diego CA 92111-7051 |
| Practice Telephone | 6192837366 |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2018-04-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 60407 | CA | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508300799 | Kelly Kim Dung Pham | Pharmacist | 6620 Summertrail Pl, Highland, CA 92346-6063 | 2016-12-07 |
| 1497136535 | Kelly Pham | Optometrist | 10934 Pebble Run Dr, Silver Spring, MD 20902-3683 | 2015-06-15 |
| 1649730557 | Kelly Pham | Student in an Organized Health Care Education/Training Program | 701 W Pratt St Rm 474, Baltimore, MD 21201-1023 | 2019-03-25 |
| 1841734126 | Kelly Pham | Dental Hygienist | 1211 Meridian Ave, San Jose, CA 95125-5210 | 2016-12-06 |
| 1295010072 | Kelly Pham | Pharmacist | 3099 Bethel Rd Se, Port Orchard, WA 98366-2432 | 2011-10-12 |
| 1114231669 | Kelly T Pham | Student in an Organized Health Care Education/Training Program | 2400 Moorpark Ave Ste 300, San Jose, CA 95128-2680 | 2010-07-27 |
| 1417274689 | Kelly Loraine Dauer Pham | Physical Medicine & Rehabilitation | 4800 Sand Point Way Ne, Department of Pediatric Rehabilitation Medicine, Seattle, WA 98105-3901 | 2010-04-28 |
| 1588641948 | Kelly H Pham | Radiology | 6600 Bruceville Rd, Sacramento, CA 95823-4671 | 2005-12-28 |
| Street Address |
3151 UNIVERSITY AVE |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92104-2039 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750322665 | Garfield Beach Cvs LLC | Pharmacy | 3151 University Ave, San Diego, CA 92104-2039 | 2006-06-10 |
| 1417564642 | Raisa-janine Dimaporo Herra | Pharmacist | 3151 University Ave, San Diego, CA 92104-2039 | 2020-10-01 |
| 1598374035 | Alvin Joseph Lobo | Pharmacist | 3151 University Ave, San Diego, CA 92104-2039 | 2020-07-30 |
| 1306494695 | Sharon Park | Pharmacist | 3151 University Ave, San Diego, CA 92104-2039 | 2019-08-29 |
| 1437718244 | Danh Thanh Nguyen | Pharmacist | 3151 University Ave, San Diego, CA 92104-2039 | 2019-06-06 |
| 1336615228 | Shelly Man Yee See | Pharmacist | 3151 University Ave, San Diego, CA 92104-2039 | 2018-10-17 |
| 1548797236 | Phuong To Thoi | Pharmacist | 3151 University Ave, San Diego, CA 92104-2039 | 2017-05-12 |
| 1255703591 | Megan White | Pharmacist | 3151 University Ave, San Diego, CA 92104-2039 | 2015-10-27 |
| 1922470285 | Mason Stewart | Pharmacist | 3151 University Ave, San Diego, CA 92104-2039 | 2015-10-27 |
| 1881066181 | Russell Tett | Pharmacist | 3151 University Ave, San Diego, CA 92104-2039 | 2015-10-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750933610 | Hinderberger Dental Corporation | Dentist | 2050 El Cajon Boulevard, San Diego, CA 92104 | 2019-07-11 |
| 1912487265 | Graham Ashton Harris | Dentist | 2310 Craven Street, Bldg 3230, Fpo, AA 92104 | 2018-08-16 |
| 1700393485 | Christian Jacot | Occupational Therapy Assistant | 3128 Nile Street, San Diego, CA 92104 | 2018-01-04 |
| 1316452931 | Enrico Resurreccion Santos | Dental Hygienist | 2310 Craven St. Bldg. 3230, San Diego, CA 92104 | 2017-12-05 |
| 1164940789 | Robert Brian Damone | Acupuncturist | 3370 29th Street, San Diego, CA 92104 | 2017-09-04 |
| 1780100636 | Nicole Palacios | Counselor | 4170 Texas Street, Apt 1, San Diego, CA 92104 | 2017-08-22 |
| 1063938587 | Indie C Oliver Landrum | Case Manager/Care Coordinator | 2220 Broadway, San Diego, CA 92104 | 2017-08-16 |
| 1669829008 | Krystah Lynn Smith | Doula | 3370 Cherokee Ave, Unit 43, San Diego, CA 92104 | 2016-05-16 |
| 1063871853 | Holly Nicole Hinderberger | Dentist | 2050 El Cajon Blvd, San Diego, CA 92104 | 2016-02-22 |
| 1316336258 | Jorge E Talavera | Military Health Care Provider | 3875 Florida St Apt 2, San Diego, CA 92104 | 2015-01-15 |
| Find all providers in zip 92104 | ||||
| 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 |
|---|---|---|---|---|
| 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 | ||||
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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.