Active NPI
Adam Kandil
- Pharmacist
- San Luis Obispo, CA
National Provider Identifier
1336705573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 35267
- Practice address
- 3960 Broad St
San Luis Obispo, CA 93401-7018 - Phone
- (805) 783-2903
- NPI assigned
- May 14, 2019
- Last updated
- May 14, 2019
- 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 | 35267 | CA | Primary |
Addresses
Primary practice location
3960 Broad St
San Luis Obispo, CA 93401-7018
Mailing address
1534 Brighton Ave Apt 17
Grover Beach, CA 93433-1868
Phone (805) 305-6565
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1234567 | Other | CA | 1234567 |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35267 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Garfield Beach CVS, L.L.C. | Past | Accepting new patients | |
| Garfield Beach CVS LLC | 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": "1557792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557792000000",
"number": "1336705573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1534 BRIGHTON AVE APT 17",
"city": "GROVER BEACH",
"state": "CA",
"postal_code": "934331868",
"telephone_number": "805-305-6565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3960 BROAD ST",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934017018",
"telephone_number": "805-783-2903"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANDIL",
"first_name": "ADAM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-05-14",
"last_updated": "2019-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "35267",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "1234567",
"identifier": "1234567",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Luis Obispo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.