Active NPI
Andrew Killeen
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- San Diego, CA
National Provider Identifier
1457762593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 69981
- Practice address
- 120 University Ave
San Diego, CA 92103 - Phone
- (619) 260-1010
- Fax
- (619) 260-1031
- NPI assigned
- May 12, 2014
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Educator | 174H00000X | |||
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 69981 | CA | Primary |
| Pharmacist | 183500000X | 69981 | CA |
Addresses
Primary practice location
120 University Ave
San Diego, CA 92103
Mailing address
120 University Ave
San Diego, CA 92103-3007
Phone (619) 260-1010
Other practice location 1
13439 Camino Canada
El Cajon, CA 92021-8811
Phone (619) 390-1146
Other practice location 2
13439 Camino Canada
El Cajon, CA 92021-8811
Phone (619) 390-1146
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vons Companies Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- 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": "1399852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553731200000",
"number": "1457762593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 UNIVERSITY AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921033007",
"telephone_number": "619-260-1010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 UNIVERSITY AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92103",
"telephone_number": "619-260-1010",
"fax_number": "619-260-1031"
}
],
"practiceLocations": [
{
"address_1": "13439 Camino Canada",
"address_purpose": "LOCATION",
"city": "El Cajon",
"state": "CA",
"postal_code": "920218811",
"country_code": "US",
"telephone_number": "619-390-1146",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "13439 Camino Canada",
"address_purpose": "LOCATION",
"city": "El Cajon",
"state": "CA",
"postal_code": "920218811",
"country_code": "US",
"telephone_number": "619-390-1146",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KILLEEN",
"first_name": "ANDREW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-05-12",
"last_updated": "2019-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": null,
"license": null,
"primary": false
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "CA",
"license": "69981",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "69981",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.