Active NPI
Andrew Magnaye
- Community/Retail Pharmacy
- Apple Valley, CA
National Provider Identifier
1043790058
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Practice address
- 19201 Bear Valley Rd
Apple Valley, CA 92308-2702 - Phone
- (760) 961-6943
- NPI assigned
- Aug 19, 2018
- 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 |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
19201 Bear Valley Rd
Apple Valley, CA 92308-2702
Mailing address
4377 Clair St
Montclair, CA 91763-6308
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 75265 | Other | CA | CALIFORNIA STATE BOARD OF PHARMACY |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534636800000",
"number": "1043790058",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4377 CLAIR ST",
"city": "MONTCLAIR",
"state": "CA",
"postal_code": "917636308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19201 BEAR VALLEY RD",
"city": "APPLE VALLEY",
"state": "CA",
"postal_code": "923082702",
"telephone_number": "760-961-6943"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAGNAYE",
"first_name": "ANDREW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-08-19",
"last_updated": "2018-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA STATE BOARD OF PHARMACY",
"identifier": "75265",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Apple Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.