Active NPI
Dennis Michael McComb, RPH
- Pharmacist
- Lodi, CA
National Provider Identifier
1184600496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28791
- Practice address
- 115 Lakewood Mall
Lodi, CA 95242-2963 - Phone
- (209) 368-2788
- Fax
- (209) 368-4951
- NPI assigned
- Dec 19, 2005
- 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 | 28791 | CA | Primary |
Addresses
Primary practice location
115 Lakewood Mall
Lodi, CA 95242-2963
Mailing address
19444 Rosewood Way
Woodbridge, CA 95258-9032
Phone (209) 334-2174
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 28791 | Other | CA | PHARMACY LICENCE NUMBER |
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 |
|---|---|---|---|
| 28791 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316736000000",
"number": "1184600496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19444 ROSEWOOD WAY",
"city": "WOODBRIDGE",
"state": "CA",
"postal_code": "952589032",
"telephone_number": "209-334-2174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 LAKEWOOD MALL",
"city": "LODI",
"state": "CA",
"postal_code": "952422963",
"telephone_number": "209-368-2788",
"fax_number": "209-368-4951"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCOMB",
"first_name": "DENNIS",
"middle_name": "MICHAEL",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-19",
"last_updated": "2011-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "28791",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY LICENCE NUMBER",
"identifier": "28791",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lodi, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.