Active NPI
Reginald Perez Tayaben, PHARM.D.
- Pharmacist
- San Bernardino, CA
National Provider Identifier
1205106630
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 66760
- Practice address
- 499 W Orange Show Rd
T-0188
San Bernardino, CA 92408-2029 - Phone
- (909) 379-0003
- Fax
- (909) 379-0005
- NPI assigned
- Jan 2, 2012
- Last updated
- Jan 2, 2012
- 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 | 66760 | CA | Primary |
Addresses
Primary practice location
499 W Orange Show Rd
T-0188
San Bernardino, CA 92408-2029
Mailing address
499 W Orange Show Rd
T-0188
San Bernardino, CA 92408-2029
Phone (909) 379-0003
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 66760 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Carolina CVS Pharmacy LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1325462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325462400000",
"number": "1205106630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "499 W ORANGE SHOW RD",
"address_2": "T-0188",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924082029",
"telephone_number": "909-379-0003",
"fax_number": "909-379-0005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "499 W ORANGE SHOW RD",
"address_2": "T-0188",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924082029",
"telephone_number": "909-379-0003",
"fax_number": "909-379-0005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAYABEN",
"first_name": "REGINALD",
"middle_name": "PEREZ",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-01-02",
"last_updated": "2012-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "66760",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.