Individual provider Active NPI

Oluwatosin Opeyemi Oluyide, B.PHARM

  • Pharmacist
  • Jackson, CA
National Provider Identifier
1184400699
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
INT49426 Issued in CA
Practice address
12110 Industry Blvd
Jackson, CA 95642-9373
Phone
(209) 257-0786
NPI assigned
Aug 31, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X INT49426 CA Primary

Addresses

Primary practice location

12110 Industry Blvd
Jackson, CA 95642-9373

Mailing address

12110 Industry Blvd
Jackson, CA 95642-9373
Phone (209) 257-0786

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

State licenses

LicenseStateTypeSpecialty
INT49426CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1693440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1184400699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12110 INDUSTRY BLVD",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956429373",
            "telephone_number": "209-257-0786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12110 INDUSTRY BLVD",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956429373",
            "telephone_number": "209-257-0786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLUYIDE",
        "first_name": "OLUWATOSIN",
        "middle_name": "OPEYEMI",
        "credential": "B.PHARM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-31",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "INT49426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.