Active NPI
Bonifacio G Dimayacyac
- Pharmacist
- Lancaster, CA
National Provider Identifier
1063795391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 63837
- Practice address
- 1834 W Avenue J
Lancaster, CA 93534-2745 - Phone
- (661) 723-0363
- NPI assigned
- Sep 22, 2011
- 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 | 63837 | CA | Primary |
Addresses
Primary practice location
1834 W Avenue J
Lancaster, CA 93534-2745
Mailing address
17758 Cape Jasmine Rd
Canyon Country, CA 91387-3817
Phone (661) 347-3567
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co. | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
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": "1316649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316649600000",
"number": "1063795391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17758 CAPE JASMINE RD",
"city": "CANYON COUNTRY",
"state": "CA",
"postal_code": "913873817",
"telephone_number": "661-347-3567"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1834 W AVENUE J",
"city": "LANCASTER",
"state": "CA",
"postal_code": "935342745",
"telephone_number": "661-723-0363"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIMAYACYAC",
"first_name": "BONIFACIO",
"middle_name": "G",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-09-22",
"last_updated": "2011-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "63837",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lancaster, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.