Active NPI
Amando Cruz Martin Jr., RPH
- Pharmacist
- Orange, CA
National Provider Identifier
1184221822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 60685
- Practice address
- 132 S Anita Dr FL 2
Orange, CA 92868-3317 - Phone
- (877) 778-3773
- Fax
- (800) 951-7948
- NPI assigned
- Oct 6, 2020
- 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 | 60685 | CA | Primary |
Addresses
Primary practice location
132 S Anita Dr FL 2
Orange, CA 92868-3317
Mailing address
21 Mirabella
Buena Park, CA 90620-4175
Phone (877) 778-3773
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 |
|---|---|---|---|
| 60685 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601942400000",
"number": "1184221822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 MIRABELLA",
"city": "BUENA PARK",
"state": "CA",
"postal_code": "906204175",
"telephone_number": "877-778-3773",
"fax_number": "800-951-7948"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "132 S ANITA DR FL 2",
"city": "ORANGE",
"state": "CA",
"postal_code": "928683317",
"telephone_number": "877-778-3773",
"fax_number": "800-951-7948"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "AMANDO",
"middle_name": "CRUZ",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-10-06",
"last_updated": "2020-10-06",
"certification_date": "2020-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "60685",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.