Individual provider Active NPI

Matthew Manuele

  • Pharmacist
  • Rancho Cordova, CA
National Provider Identifier
1497128102
Registry record updated Nov 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
73006 Issued in CA
Practice address
2111 Golden Centre LN
Rancho Cordova, CA 95670-4477
Phone
(916) 858-1948
NPI assigned
Nov 3, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 73006 CA Primary

Addresses

Primary practice location

2111 Golden Centre LN
Rancho Cordova, CA 95670-4477

Mailing address

2111 Golden Centre LN
Rancho Cordova, CA 95670-4477
Phone (916) 858-1948

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
73006CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1446508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446508800000",
    "number": "1497128102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 GOLDEN CENTRE LN",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956704477",
            "telephone_number": "916-858-1948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 GOLDEN CENTRE LN",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956704477",
            "telephone_number": "916-858-1948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANUELE",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-03",
        "last_updated": "2015-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "73006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cordova, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2015; 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.