Active NPI
Jeff Ruggles
- Pharmacist
- San Diego, CA
National Provider Identifier
1023547064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 54378
- Practice address
- 1075 Camino del Rio S
San Diego, CA 92108-3538 - Phone
- (619) 881-5094
- Fax
- (866) 886-7824
- NPI assigned
- Jun 4, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 54378 | CA | Primary |
Addresses
Primary practice location
1075 Camino del Rio S
San Diego, CA 92108-3538
Mailing address
10058 Rock Meadow Rd
Lakeside, CA 92040-2784
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54378 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661731200000",
"number": "1023547064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10058 ROCK MEADOW RD",
"city": "LAKESIDE",
"state": "CA",
"postal_code": "920402784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1075 CAMINO DEL RIO S",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921083538",
"telephone_number": "619-881-5094",
"fax_number": "866-886-7824"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUGGLES",
"first_name": "JEFF",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-06-04",
"last_updated": "2022-08-29",
"certification_date": "2022-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "54378",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.