Active NPI
Glenn Bryan Morataya, PHARM. D.
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Montclair, CA
National Provider Identifier
1609247683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- RPH72409
- Practice address
- 5000 San Bernardino St
Montclair, CA 91763-2326 - Phone
- (909) 625-8371
- NPI assigned
- Oct 15, 2015
- 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 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH72409 | CA | |
| Geriatric Pharmacist | 1835G0303X | RPH72409 | CA | |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | RPH72409 | CA | Primary |
| Pharmacotherapy Pharmacist | 1835P1200X | RPH72409 | CA | |
| Psychiatric Pharmacist | 1835P1300X | RPH72409 | CA | |
| Ambulatory Care Pharmacist | 1835P2201X | RPH72409 | CA |
Addresses
Primary practice location
5000 San Bernardino St
Montclair, CA 91763-2326
Mailing address
479 Carleton Ave
Claremont, CA 91711-5109
Phone (626) 222-6687
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 |
|---|---|---|---|
| RPH72409 | CA | MD | Psychiatric Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444867200000",
"number": "1609247683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "479 CARLETON AVE",
"city": "CLAREMONT",
"state": "CA",
"postal_code": "917115109",
"telephone_number": "626-222-6687"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5000 SAN BERNARDINO ST",
"city": "MONTCLAIR",
"state": "CA",
"postal_code": "917632326",
"telephone_number": "909-625-8371"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORATAYA",
"first_name": "GLENN",
"middle_name": "BRYAN",
"name_prefix": "Dr.",
"credential": "PHARM. D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-10-15",
"last_updated": "2015-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "RPH72409",
"primary": false
},
{
"code": "1835G0303X",
"taxonomy_group": "",
"desc": "Pharmacist, Geriatric",
"state": "CA",
"license": "RPH72409",
"primary": false
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "CA",
"license": "RPH72409",
"primary": true
},
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "CA",
"license": "RPH72409",
"primary": false
},
{
"code": "1835P1300X",
"taxonomy_group": "",
"desc": "Pharmacist, Psychiatric",
"state": "CA",
"license": "RPH72409",
"primary": false
},
{
"code": "1835P2201X",
"taxonomy_group": "",
"desc": "Pharmacist, Ambulatory Care",
"state": "CA",
"license": "RPH72409",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montclair, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.