Individual provider Active NPI

Joe Anigbogu, PHARMD, RPH

  • Pharmacist
  • Lake Elsinore, CA
National Provider Identifier
1053094508
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
88058 Issued in CA
Practice address
29260 Central Ave
Lake Elsinore, CA 92532-2232
Phone
(951) 245-4329
NPI assigned
Aug 10, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 88058 CA Primary

Addresses

Primary practice location

29260 Central Ave
Lake Elsinore, CA 92532-2232

Mailing address

31778 Camino Rosales
Temecula, CA 92592-1042
Phone (951) 553-0280

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, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
88058CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Walmart Inc. CurrentSince Aug 13, 2023 Accepting new patients
Walmart Inc. PastSince Aug 13, 2023 Accepting new patients

Locations

29260 Central Ave
Lake Elsinore, CA 92532
Phone (951) 245-4329

Organizations & group practices 2

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": "1691625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1053094508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31778 CAMINO ROSALES",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925921042",
            "telephone_number": "951-553-0280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29260 CENTRAL AVE",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925322232",
            "telephone_number": "951-245-4329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANIGBOGU",
        "first_name": "JOE",
        "name_prefix": "Dr.",
        "credential": "PHARMD, RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-10",
        "last_updated": "2023-08-10",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "88058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Elsinore, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; 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.