Individual provider Active NPI

Eglis Ismar Tellez-Corrales, PHARMD

  • Ambulatory Care Pharmacist
  • Sacramento, CA
National Provider Identifier
1265872113
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care PharmacistTaxonomy code 1835P2201X
License
62476 Issued in CA
Practice address
1020 29TH St Ste 690
Sacramento, CA 95816-5126
Phone
(916) 887-4670
NPI assigned
Jun 25, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Pharmacist 1835P2201X 62476 CA Primary

Addresses

Primary practice location

1020 29TH St Ste 690
Sacramento, CA 95816-5126

Mailing address

2350 Harbor Blvd Apt 103
Costa Mesa, CA 92626-6258

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

Interoperability endpoints

  • Direct secure messaging: etellezcorrales714714@hisp.ehr.sutterhealth.org

NPI Registry JSON

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1265872113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 HARBOR BLVD APT 103",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926266258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 29TH ST STE 690",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165126",
            "telephone_number": "916-887-4670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELLEZ-CORRALES",
        "first_name": "EGLIS",
        "middle_name": "ISMAR",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-25",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "CA",
            "license": "62476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2025; 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.