Active NPI
Matthew Paul Sierra, PHARMD
- Pharmacist
- Moreno Valley, CA
National Provider Identifier
1245638691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 72176
- Practice address
- 25070 Alessandro Blvd
Moreno Valley, CA 92553-4313 - Phone
- (951) 242-4770
- NPI assigned
- Dec 17, 2014
- 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 | 72176 | CA | Primary |
Addresses
Primary practice location
25070 Alessandro Blvd
Moreno Valley, CA 92553-4313
Mailing address
1601 Barton Rd Apt 803
Redlands, CA 92373-5333
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 |
|---|---|---|---|
| 72176 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Longs Drug Store California 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 and National Provider Directory roles.
-
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- Kapolei, HI
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1418774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418774400000",
"number": "1245638691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1601 BARTON RD APT 803",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923735333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25070 ALESSANDRO BLVD",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925534313",
"telephone_number": "951-242-4770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIERRA",
"first_name": "MATTHEW",
"middle_name": "PAUL",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-12-17",
"last_updated": "2014-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "72176",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Moreno Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.