Active NPI
Felbert Balandra Maningo, RPH
- Pharmacist
- Yucaipa, CA
National Provider Identifier
1073395265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH88638
- Practice address
- 33499 Yucaipa Blvd
Yucaipa, CA 92399-2064 - Phone
- (909) 797-9350
- NPI assigned
- Oct 20, 2023
- 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 | RPH88638 | CA | Primary |
Addresses
Primary practice location
33499 Yucaipa Blvd
Yucaipa, CA 92399-2064
Mailing address
263 E Kingman St
San Bernardino, CA 92410-4845
Phone (909) 556-7878
Other practice location 1
263 E Kingman St
San Bernardino, CA 92410-4845
Phone (909) 556-7878
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 |
|---|---|---|---|
| RPH88638 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1697760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697760000000",
"number": "1073395265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "263 E KINGMAN ST",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924104845",
"telephone_number": "909-556-7878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33499 YUCAIPA BLVD",
"city": "YUCAIPA",
"state": "CA",
"postal_code": "923992064",
"telephone_number": "909-797-9350"
}
],
"practiceLocations": [
{
"address_1": "263 E Kingman St",
"address_purpose": "LOCATION",
"city": "San Bernardino",
"state": "CA",
"postal_code": "924104845",
"country_code": "US",
"telephone_number": "909-556-7878",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MANINGO",
"first_name": "FELBERT",
"middle_name": "BALANDRA",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-10-20",
"last_updated": "2023-10-20",
"certification_date": "2023-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "RPH88638",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yucaipa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.