Active NPI
Ellis Anthony Bloch
- Pharmacist
- San Diego, CA
National Provider Identifier
1033422993
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 42003
- Practice address
- 4605 Morena Blvd
San Diego, CA 92117-3650 - Phone
- (858) 581-4550
- Fax
- (858) 581-4224
- NPI assigned
- Jul 21, 2010
- Sex
- Male
- Sole proprietor
- No
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 | 42003 | CA | Primary |
Addresses
Primary practice location
4605 Morena Blvd
San Diego, CA 92117-3650
Mailing address
12671 Monterey Cypress Way
San Diego, CA 92130-2423
Phone (858) 361-4332
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 |
|---|---|---|---|
| 42003 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1279670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1279670400000",
"number": "1033422993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12671 MONTEREY CYPRESS WAY",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921302423",
"telephone_number": "858-361-4332",
"fax_number": "858-581-4224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4605 MORENA BLVD",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921173650",
"telephone_number": "858-581-4550",
"fax_number": "858-581-4224"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLOCH",
"first_name": "ELLIS",
"middle_name": "ANTHONY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-07-21",
"last_updated": "2010-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "42003",
"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 Jul 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.