Individual provider Active NPI

Nicole Sangalang, PHARM.D.

  • Pharmacist
  • Lake Elsinore, CA
National Provider Identifier
1205251592
Registry record updated Feb 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
67654 Issued in CA
Practice address
160 Diamond Dr
Lake Elsinore, CA 92530-4401
Phone
(951) 674-3562
Fax
(951) 674-3702
NPI assigned
Feb 24, 2014
Last updated
Feb 24, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 67654 CA Primary

Addresses

Primary practice location

160 Diamond Dr
Lake Elsinore, CA 92530-4401

Mailing address

160 Diamond Dr
Lake Elsinore, CA 92530-4401
Phone (951) 674-3562

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

LicenseStateTypeSpecialty
67654CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co PastSince Apr 17, 2022 Accepting new patients
Walgreen Co Past Accepting new patients

Organizations & group practices 2

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": "1393200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393200000000",
    "number": "1205251592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 DIAMOND DR",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304401",
            "telephone_number": "951-674-3562",
            "fax_number": "951-674-3702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 DIAMOND DR",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304401",
            "telephone_number": "951-674-3562",
            "fax_number": "951-674-3702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANGALANG",
        "first_name": "NICOLE",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-24",
        "last_updated": "2014-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "67654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Elsinore, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2014; 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.