GRACE MUN (NPI# 1114270733) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114270733 |
| Entity Type | Individual |
| Full Name | GRACE MUN |
| Credential | PHARMD |
| Practice Address |
5787 Alta Vista Way Fontana CA 92336-5611 |
| Practice Telephone | 4252207286 |
| Mailing Telephone | 4252207286 |
| Enumeration Date | 2012-10-19 |
| Last Update Date | 2012-10-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
PH60047 | WA | Pharmacy Service Providers |
| Street Address |
5787 ALTA VISTA WAY |
| City | FONTANA |
| State | CA |
| Zip Code | 92336-5611 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700361243 | Schmidt and Jefferson Dental Corporation | Dentist | 16944 South Highland Avenue, Ste. 400, Fontana, CA 92336 | 2018-10-01 |
| 1275032658 | Kenitha Pulliam | Behavioral Analyst | 14051 Catalina Ct, Fontana, CA 92336 | 2018-02-12 |
| 1568961183 | Jordan Frailey | Marriage & Family Therapist | 9161 Sierra Ave. Suite 213, Fontana, CA 92336 | 2018-02-09 |
| 1689198905 | Sara Alyssa Lynch | Specialist/Technologist | 7151 Oak Tree Place, Fontana, CA 92336 | 2017-07-28 |
| 1043749526 | Eric Ceasar Parian Lopez | Registered Nurse | 16001 Pfc Paris Montanez Dr., Fontana, CA 92336 | 2017-06-08 |
| 1275065393 | Alyssa Calderon | Marriage & Family Therapist | 14335 Quail Ct, Fontana, CA 92336 | 2017-03-29 |
| 1588029219 | Daisy Maritza Santana | Behavioral Analyst | 16320 Rosa Linda Ln, Fontana, CA 92336 | 2015-12-23 |
| 1407237498 | Natalie Kathleen Herrera | Physician Assistant | 16456 Sierra Lakes Pkwy, Suite 300, Fontana, CA 92336 | 2015-06-15 |
| 1255738241 | Southern California Picc Providers, Inc. | Spec/Tech, Cardiovascular | 5787 Little Shay Dr, Fontana, CA 92336 | 2014-11-19 |
| 1396175758 | Martha C Ajca | Physician Assistant | 17051 Sierra Lakes Parkway, Suite 101, Fontana, CA 92336 | 2013-11-22 |
| Find all providers in zip 92336 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710217823 | Vikram J Patel | Pharmacist | 16137 Foothill Blvd, Fontana, CA 92335-3374 | 2010-01-12 |
| 1962769273 | Julius Chang | Pharmacist | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2012-04-12 |
| 1730471087 | Tien Thuy Nguyen | Pharmacist | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2011-05-04 |
| 1700180189 | Jenny Y Chung | Pharmacist | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2010-12-29 |
| 1861629768 | Katheen Schilli | Pharmacist | 7426 Cherry Ave, Suite 210, Pmb 160, Fontana, CA 92336-4221 | 2009-06-17 |
| 1215161682 | Irma Wassif Shenouda | Pharmacist | 17296 Slover Ave, Fontana, CA 92337-7585 | 2009-05-13 |
| 1891935771 | Joyce Chung See Wong | Pharmacist | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2009-03-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376142430 | Daria Mohazzab Hosseinian | Pharmacist | 450 E Spring St Ste 11, Long Beach, CA 90806-1625 | 2020-10-20 |
| 1235745100 | Ngoc Tran | Pharmacist | 10371 Luders Ave, Garden Grove, CA 92843-3213 | 2020-09-16 |
| 1275143752 | Sherine Ann Legge | Pharmacist | 17 Westchester Ct, Trabuco Canyon, CA 92679-4955 | 2020-08-09 |
| 1922618412 | Ashley Keane Hayes | Pharmacist | 6551 E El Pulcro St, Long Beach, CA 90815-2302 | 2020-08-09 |
| 1750991543 | Priyankumar Arvind Patel | Pharmacist | 2339 S G St, Fresno, CA 93721-3425 | 2020-08-05 |
| 1912521261 | Sharon Jung | Pharmacist | 851 Langholm Way, Riverside, CA 92508-6075 | 2020-06-02 |
| 1710500376 | Christine Nguyen | Pharmacist | 2248 E Nyon Ave, Anaheim, CA 92806-4634 | 2020-05-18 |
| 1134740582 | Cj3m Corporation | Pharmacist | 2626 El Camino Real Ste A, Carlsbad, CA 92008-1253 | 2020-04-27 |
| 1629607775 | Tiffany Chang | Pharmacist | 213 Quarry Rd Rm 2726a, Palo Alto, CA 94304-1416 | 2020-04-01 |
| 1124655782 | Noor Mikhail | Pharmacist | 220 W Main St Ste 102, El Cajon, CA 92020-3462 | 2020-03-24 |
| Find all providers with the same taxonomy | ||||
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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.