Individual provider Active NPI

Angel S Malabanan Jr., RPH

  • Pharmacist
  • Sparks, NV
National Provider Identifier
1528341849
Registry record updated Sep 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
16245 Issued in NV
Practice address
1705 Canyon Terrace Dr
Sparks, NV 89436-3628
Phone
(775) 677-6874
NPI assigned
Sep 22, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 16245 NV Primary

Addresses

Primary practice location

1705 Canyon Terrace Dr
Sparks, NV 89436-3628

Mailing address

1705 Canyon Terrace Dr
Sparks, NV 89436-3628

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

LicenseStateTypeSpecialty
16245NVMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1316649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316649600000",
    "number": "1528341849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 CANYON TERRACE DR",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894363628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 CANYON TERRACE DR",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894363628",
            "telephone_number": "775-677-6874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALABANAN",
        "first_name": "ANGEL",
        "middle_name": "S",
        "name_suffix": "Jr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-22",
        "last_updated": "2011-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NV",
            "license": "16245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparks, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; 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.