Active NPI
Sydney Fuertes, RPH
- Pharmacist
- San Diego, CA
National Provider Identifier
1073376919
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 88741
- 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
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 | 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
| License | State | Type | Specialty |
|---|---|---|---|
| 88741 | CA | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Garfield Beach CVS, L.L.C. | Current | Accepting new patients | |
| Garfield Beach CVS, L.L.C. | Past | 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.
-
- Pharmacy
- San Diego, CA
- NPI 1174304372
-
- Pharmacy
- Jurupa Valley, CA
- NPI 1780573113
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.