Individual provider Active NPI

Sydney Fuertes, RPH

  • Pharmacist
  • San Diego, CA
National Provider Identifier
1073376919
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
88741 Issued in CA
Practice address
4301 Park Blvd.
San Diego, CA 92103
Phone
(619) 695-5731
Fax
(619) 420-7669
NPI assigned
Feb 2, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 88741 CA Primary

Addresses

Primary practice location

4301 Park Blvd.
San Diego, CA 92103

Mailing address

4382 40TH St
San Diego, CA 92105-1019
Phone (949) 212-6981

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

State licenses

LicenseStateTypeSpecialty
88741CAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Garfield Beach CVS, L.L.C. CurrentSince Feb 4, 2024 Accepting new patients
Garfield Beach CVS, L.L.C. PastSince Feb 4, 2024 Accepting new patients

Locations

4301 Park Blvd
San Diego, CA 92103
Phone (619) 695-5731

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": "1706832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1073376919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4382 40TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921051019",
            "telephone_number": "949-212-6981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 PARK BLVD.",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92103",
            "telephone_number": "619-695-5731",
            "fax_number": "619-420-7669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUERTES",
        "first_name": "SYDNEY",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-02",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "88741",
            "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 Feb 2, 2024; 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.