Provider Demographics
NPI:1659487742
Name:JAMES S. PAI
Entity Type:Organization
Organization Name:JAMES S. PAI
Other - Org Name:THE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:SUNGJIN
Authorized Official - Last Name:PAI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:714-995-4161
Mailing Address - Street 1:3055 W ORANGE AVE
Mailing Address - Street 2:SUITE # 108
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-3159
Mailing Address - Country:US
Mailing Address - Phone:714-995-4161
Mailing Address - Fax:714-995-4150
Practice Address - Street 1:3055 W ORANGE AVE
Practice Address - Street 2:SUITE # 108
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-3159
Practice Address - Country:US
Practice Address - Phone:714-995-4161
Practice Address - Fax:714-995-4150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY 47383333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA47383Medicaid
CA47383Medicaid
CA6088210001Medicare NSC