Active NPI
Andrew Tadang, PHARMD
- Pharmacist
- Hesperia, CA
National Provider Identifier
1215538962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 83494
- Practice address
- 17051 Bear Valley Rd
Hesperia, CA 92345-1845 - Phone
- (760) 948-7901
- NPI assigned
- Nov 7, 2020
- Last updated
- Nov 12, 2020
- 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 | 83494 | CA | Primary |
Addresses
Primary practice location
17051 Bear Valley Rd
Hesperia, CA 92345-1845
Mailing address
20376 E Crestline Dr
Walnut, CA 91789-4609
Phone (909) 569-9771
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 |
|---|---|---|---|
| 83494 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | 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": "1604707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605139200000",
"number": "1215538962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20376 E CRESTLINE DR",
"city": "WALNUT",
"state": "CA",
"postal_code": "917894609",
"telephone_number": "909-569-9771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17051 BEAR VALLEY RD",
"city": "HESPERIA",
"state": "CA",
"postal_code": "923451845",
"telephone_number": "760-948-7901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TADANG",
"first_name": "ANDREW",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-07",
"last_updated": "2020-11-12",
"certification_date": "2020-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "83494",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hesperia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.