Active NPI
Edson Fernando Rodriguez, PHARM.D.
- Pharmacy
- Northridge, CA
National Provider Identifier
1578311387
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- RPH89325
- Practice address
- 9619 Corbin Ave
Northridge, CA 91324-2121 - Phone
- (818) 605-5085
- NPI assigned
- May 7, 2024
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacy | 333600000X | RPH89325 | CA | Primary |
Addresses
Primary practice location
9619 Corbin Ave
Northridge, CA 91324-2121
Mailing address
9619 Corbin Ave
Northridge, CA 91324-2121
Phone (818) 605-5085
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RPH89325 | Other | CA | BOARD OF PHARMACY |
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH89325 | CA | MD | Pharmacy |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715040000000",
"number": "1578311387",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9619 CORBIN AVE",
"city": "NORTHRIDGE",
"state": "CA",
"postal_code": "913242121",
"telephone_number": "818-605-5085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9619 CORBIN AVE",
"city": "NORTHRIDGE",
"state": "CA",
"postal_code": "913242121",
"telephone_number": "818-605-5085"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "EDSON",
"middle_name": "FERNANDO",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-05-07",
"last_updated": "2024-05-07",
"certification_date": "2024-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "CA",
"license": "RPH89325",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF PHARMACY",
"identifier": "RPH89325",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Northridge, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.