Individual provider Active NPI

Brandon Daniel Decastro, PHARMD

  • Pharmacist
  • San Diego, CA
National Provider Identifier
1235801242
Registry record updated Sep 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
85098 Issued in CA
Practice address
10675 Scripps Poway Pkwy
San Diego, CA 92131-3919
Phone
(858) 693-1545
NPI assigned
Sep 29, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 85098 CA Primary

Addresses

Primary practice location

10675 Scripps Poway Pkwy
San Diego, CA 92131-3919

Mailing address

10675 Scripps Poway Pkwy
San Diego, CA 92131-3919
Phone (858) 693-1545

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
85098CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Vons Companies Inc PastSince Oct 5, 2021 Accepting new patients
Vons Companies Inc PastSince Oct 5, 2021 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1632873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1235801242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10675 SCRIPPS POWAY PKWY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921313919",
            "telephone_number": "858-693-1545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10675 SCRIPPS POWAY PKWY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921313919",
            "telephone_number": "858-693-1545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECASTRO",
        "first_name": "BRANDON",
        "middle_name": "DANIEL",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-29",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "85098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2021; 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.