Active NPI
Dominga Marquez De Vera, RPH
- Pharmacist
- Brawley, CA
National Provider Identifier
1396046983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 59191
- Practice address
- 475 West Main Street
Vons Pharmacy
Brawley, CA 92227 - Phone
- (760) 351-3007
- Fax
- (760) 351-3012
- NPI assigned
- Nov 12, 2010
- Last updated
- Nov 12, 2010
- Sex
- Female
- 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 | 59191 | CA | Primary |
Addresses
Primary practice location
475 West Main Street
Vons Pharmacy
Brawley, CA 92227
Mailing address
475 West Main Street
Vons Pharmacy
Brawley, CA 92227
Phone (760) 351-3007
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 59191 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vons Companies Inc | Past | Accepting new patients | |
| Vons Companies 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Vons Pharmacy #0286
- Community/Retail Pharmacy
- Santa Monica, CA
- NPI 1720879919
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1289520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289520000000",
"number": "1396046983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "475 WEST MAIN STREET",
"address_2": "VONS PHARMACY",
"city": "BRAWLEY",
"state": "CA",
"postal_code": "92227",
"telephone_number": "760-351-3007",
"fax_number": "760-351-3012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "475 WEST MAIN STREET",
"address_2": "VONS PHARMACY",
"city": "BRAWLEY",
"state": "CA",
"postal_code": "92227",
"telephone_number": "760-351-3007",
"fax_number": "760-351-3012"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE VERA",
"first_name": "DOMINGA",
"middle_name": "MARQUEZ",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-11-12",
"last_updated": "2010-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "59191",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brawley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.