Individual provider Active NPI

Mark James Moreno, PHARM. D

  • Pharmacist
  • Fresno, CA
National Provider Identifier
1578997730
Registry record updated Aug 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
68517 Issued in CA
Practice address
6859 E Simpson Ave
Fresno, CA 93727-1448
Phone
(401) 440-7807
NPI assigned
Aug 23, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 68517 CA Primary

Addresses

Primary practice location

6859 E Simpson Ave
Fresno, CA 93727-1448

Mailing address

6859 E Simpson Ave
Fresno, CA 93727-1448
Phone (401) 440-7807

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

NPI Registry JSON

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

{
    "created_epoch": "1377216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377216000000",
    "number": "1578997730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6859 E SIMPSON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937271448",
            "telephone_number": "401-440-7807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6859 E SIMPSON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937271448",
            "telephone_number": "401-440-7807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "MARK",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "PHARM. D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-23",
        "last_updated": "2013-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "68517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2013; 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.