Active NPI
Matthew Geidel, PHARMD
- Pharmacist
- San Luis Obispo, CA
National Provider Identifier
1104335173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 77020
- Practice address
- 956 E Foothill Blvd
San Luis Obispo, CA 93405-1762 - Phone
- (805) 543-5697
- NPI assigned
- Sep 21, 2017
- 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 | 77020 | CA | Primary |
Addresses
Primary practice location
956 E Foothill Blvd
San Luis Obispo, CA 93405-1762
Mailing address
1325 Breck St
San Luis Obispo, CA 93401-3020
Phone (620) 217-5701
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 77020 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thrifty Payless Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Retail Pharmacy
- Winchester, CA
- NPI 1437874062
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505952000000",
"number": "1104335173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1325 BRECK ST",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934013020",
"telephone_number": "620-217-5701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "956 E FOOTHILL BLVD",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934051762",
"telephone_number": "805-543-5697"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEIDEL",
"first_name": "MATTHEW",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-09-21",
"last_updated": "2017-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "77020",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Luis Obispo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.