Individual provider Active NPI

Jerry Don Oswald, PHARMD

  • Pharmacist
  • Tustin, CA
National Provider Identifier
1003574963
Registry record updated Dec 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
31903 Issued in CA
Practice address
13400 Newport Ave
Tustin, CA 92780-3753
Phone
(714) 731-1344
Fax
(714) 731-7363
NPI assigned
Dec 7, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 31903 CA Primary

Addresses

Primary practice location

13400 Newport Ave
Tustin, CA 92780-3753

Mailing address

13400 Newport Ave
Tustin, CA 92780-3753
Phone (714) 731-1344

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
31903CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Tustin Community Pharmacy Inc CurrentSince Dec 12, 2021 Accepting new patients
Tustin Community Pharmacy Inc Current Accepting new patients
Tustin Pharmacy, Inc. PastSince Dec 12, 2021 Accepting new patients

Locations

13400 Newport Ave
Tustin, CA 92780
Phone (714) 276-4304

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1638835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1003574963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13400 NEWPORT AVE",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803753",
            "telephone_number": "714-731-1344",
            "fax_number": "714-731-7363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13400 NEWPORT AVE",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803753",
            "telephone_number": "714-731-1344",
            "fax_number": "714-731-7363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSWALD",
        "first_name": "JERRY",
        "middle_name": "DON",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-07",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "31903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.