Active NPI
Kevin Bumanglag
- Pharmacist
- San Francisco, CA
National Provider Identifier
1407632490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 88398
- Practice address
- 500 Parnassus Ave RM Mu-145
San Francisco, CA 94143-2203 - Phone
- (415) 681-3394
- NPI assigned
- Sep 5, 2023
- 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 | 88398 | CA | Primary |
Addresses
Primary practice location
500 Parnassus Ave RM Mu-145
San Francisco, CA 94143-2203
Mailing address
2125 Pettigrew CT
Stockton, CA 95210-6771
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 |
|---|---|---|---|
| 88398 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
500 Parnassus Ave
Rm MU145
San Francisco, CA 94143
Phone (415) 681-3394
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.
-
- Pharmacy
- San Francisco, CA
- NPI 1053732107
-
- Pharmacy
- Longview, TX
- NPI 1629956545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693872000000",
"number": "1407632490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2125 PETTIGREW CT",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952106771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 PARNASSUS AVE RM MU-145",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941432203",
"telephone_number": "415-681-3394"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUMANGLAG",
"first_name": "KEVIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-09-05",
"last_updated": "2023-09-05",
"certification_date": "2023-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "88398",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.