Active NPI
Sycuan Tribal Government
- Community/Retail Pharmacy
- El Cajon, CA
National Provider Identifier
1164553053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PHE39873
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2094469 | Other | PK |
Other names 2
- SYCUAN HEALTH CENTER PHARMACY
- SYCUAN MEDICAL DENTAL PHARMACY
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D0566375 | Sycuan Health Center | Certificate of waiver | Jul 29, 2026 |
National Provider Directory
National Provider Directory- Tax ID family
- Sycuan Tribal Government
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Clinic/Center
- El Cajon, CA
- NPI 1629056999
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.