Individual provider Active NPI

Sherwin Babadilla Samson

  • Pharmacist
  • San Leandro, CA
National Provider Identifier
1376863001
Registry record updated Jun 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH 59357 Issued in CA
Practice address
1355 Macarthur Blvd
San Leandro, CA 94577-3918
Phone
(510) 352-3677
Fax
(510) 352-7102
NPI assigned
Jun 4, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH 59357 CA Primary

Addresses

Primary practice location

1355 Macarthur Blvd
San Leandro, CA 94577-3918

Mailing address

947 Fletcher LN Apt 223
Hayward, CA 94544-1063
Phone (510) 331-6198

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

LicenseStateTypeSpecialty
RPH 59357CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Thrifty Payless Inc Past Accepting new patients
Thrifty Payless Inc 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1275609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275609600000",
    "number": "1376863001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "947 FLETCHER LN APT 223",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945441063",
            "telephone_number": "510-331-6198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 MACARTHUR BLVD",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945773918",
            "telephone_number": "510-352-3677",
            "fax_number": "510-352-7102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMSON",
        "first_name": "SHERWIN",
        "middle_name": "BABADILLA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-04",
        "last_updated": "2010-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH 59357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2010; 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.