NY MIM PHARM D
NPI 1689651309
Pharmacist in Modesto, CA

Active since December 22, 2005
2100 STANDIFORD AVE, MODESTO, CA 95350(209) 577-1350(209) 577-1409 Get Directions Write a Review

NPPES record last updated: August 14, 2007. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Ny Mim Pharm D NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NY MIM PHARM D (NPI 1689651309) is an individual pharmacist in Modesto, California, licensed in California (48317) and active in the NPI registry since December 2005.

NPPES Registry Identity

NPI1689651309
Entity TypeIndividualMale
Primary Taxonomy183500000X
Provider Legal NameNY MIMCredential: PHARM D
Location Address2100 STANDIFORD AVEModesto, CA 95350-6522
Mailing Address4000 Bella Tuscany DrModesto, CA 95356-9339
Fax(209) 577-1409
Sole ProprietorNo
Enumeration DateDecember 22, 2005
Last NPPES UpdateAugust 14, 2007
NPI 1689651309 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
License Licensed in CA · 48317
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.

2100 STANDIFORD AVE, Modesto, CA 95350

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Technician, Other
2100 STANDIFORD AVE, SUITE 12-180
MODESTO, CA 95350
Assistant Behavior Analyst
2100 STANDIFORD AVE
MODESTO, CA 95350

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1689651309, enumerated as an "individual" on December 22, 2005.

The provider is located at 2100 STANDIFORD AVE MODESTO, CA 95350 and the phone number is (209) 577-1350.

Pharmacist with taxonomy code 183500000X.