Active NPI
William N Burdine, III, R.PH
- Pharmacist
- San Diego, CA
National Provider Identifier
1164593885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 31975
- Practice address
- 5555 Reservoir Dr
Suite #114
San Diego, CA 92120-5134 - Phone
- (619) 287-5035
- Fax
- (619) 287-5098
- NPI assigned
- Nov 13, 2006
- Sex
- Male
- 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 | 31975 | CA | Primary |
Addresses
Primary practice location
5555 Reservoir Dr
Suite #114
San Diego, CA 92120-5134
Mailing address
10831 Del Rio Rd
Spring Valley, CA 91978-1215
Phone (619) 670-6257
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31975 | Other | CA | R.PH LICENSE NO. |
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 |
|---|---|---|---|
| 31975 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164593885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10831 DEL RIO RD",
"city": "SPRING VALLEY",
"state": "CA",
"postal_code": "919781215",
"telephone_number": "619-670-6257"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5555 RESERVOIR DR",
"address_2": "SUITE #114",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921205134",
"telephone_number": "619-287-5035",
"fax_number": "619-287-5098"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURDINE, III",
"first_name": "WILLIAM",
"middle_name": "N",
"credential": "R.PH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "31975",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "R.PH LICENSE NO.",
"identifier": "31975",
"state": "CA"
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.