Individual provider Active NPI

Omar Deleon, PHARM.D.

  • Pharmacist
  • Harbor City, CA
National Provider Identifier
1306318902
Registry record updated Dec 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH80005 Issued in CA
Practice address
25825 South Vermont Ave
North Hospital - Pharmacy Administration
Harbor City, CA 90710-3518
Phone
(310) 517-2245
NPI assigned
Dec 20, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH80005 CA Primary

Addresses

Primary practice location

25825 South Vermont Ave
North Hospital - Pharmacy Administration
Harbor City, CA 90710-3518

Mailing address

23048 Archibald Ave
Carson, CA 90745-4717
Phone (310) 387-1752

Other identifiers 1

IdentifierTypeStateIssuer
RPH80005OtherCACA BOARD OF PHARMACY

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
RPH80005CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1545264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545264000000",
    "number": "1306318902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23048 ARCHIBALD AVE",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907454717",
            "telephone_number": "310-387-1752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25825 SOUTH VERMONT AVE",
            "address_2": "NORTH HOSPITAL - PHARMACY ADMINISTRATION",
            "city": "HARBOR CITY",
            "state": "CA",
            "postal_code": "907103518",
            "telephone_number": "310-517-2245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELEON",
        "first_name": "OMAR",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-20",
        "last_updated": "2018-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH80005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA BOARD OF PHARMACY",
            "identifier": "RPH80005",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harbor City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2018; 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.