Organization Active NPI

Sycuan Tribal Government

  • Community/Retail Pharmacy
  • El Cajon, CA
National Provider Identifier
1164553053
Registry record updated Feb 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHE39873 Issued in CA
Legal business name
SYCUAN TRIBAL GOVERNMENT
Practice address
4921 Dehesa Rd
El Cajon, CA 92019-2929
Phone
(619) 445-0707
Fax
(619) 445-0901
NPI assigned
Mar 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2026

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

Authorized official

Name
Maurice Smith
Title
Executive Director
Phone
(619) 445-0707

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHE39873 CA Primary

Addresses

Primary practice location

4921 Dehesa Rd
El Cajon, CA 92019-2929

Mailing address

4921 Dehesa Rd
El Cajon, CA 92019-2929
Phone (619) 445-0707

Other identifiers 1

IdentifierTypeStateIssuer
2094469OtherPK

Other names 2

  • SYCUAN HEALTH CENTER PHARMACY Doing business as
  • SYCUAN MEDICAL DENTAL PHARMACY Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0566375Sycuan Health Center4921 Dehesa Rd, El Cajon, CA 92019Certificate of waiverJul 29, 2026

National Provider Directory

National Provider Directory
Tax ID family
Sycuan Tribal Government2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770940800000",
    "number": "1164553053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4921 DEHESA RD",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920192929",
            "telephone_number": "619-445-0707",
            "fax_number": "619-445-0901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4921 DEHESA RD",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920192929",
            "telephone_number": "619-445-0707",
            "fax_number": "619-445-0901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYCUAN TRIBAL GOVERNMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2026-02-13",
        "certification_date": "2026-02-13",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MAURICE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "619-445-0707"
    },
    "taxonomies": [
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHE39873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2094469",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SYCUAN HEALTH CENTER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SYCUAN MEDICAL DENTAL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in El Cajon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.