Individual provider Active NPI

John Leuck Jr., RPH

  • Pharmacist
  • San Diego, CA
National Provider Identifier
1053704015
Registry record updated Mar 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
44217 Issued in CA
Practice address
3345 Sports Arena Blvd
San Diego, CA 92110-4567
Phone
(619) 222-5818
Fax
(619) 222-5879
NPI assigned
Mar 13, 2015
Last updated
Mar 13, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 44217 CA Primary

Addresses

Primary practice location

3345 Sports Arena Blvd
San Diego, CA 92110-4567

Mailing address

4414 Marseilles St
San Diego, CA 92107-4236
Phone (619) 997-8354

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
Registered Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1426204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426204800000",
    "number": "1053704015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4414 MARSEILLES ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921074236",
            "telephone_number": "619-997-8354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3345 SPORTS ARENA BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104567",
            "telephone_number": "619-222-5818",
            "fax_number": "619-222-5879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEUCK",
        "first_name": "JOHN",
        "name_suffix": "Jr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-13",
        "last_updated": "2015-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "44217",
            "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 Mar 13, 2015; 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.