Individual provider Active NPI

George Edward Benedetto Jr., RPH

  • Pharmacist
  • Lake Forest, CA
National Provider Identifier
1609316009
Registry record updated Mar 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH30028 Issued in CA
Practice address
1 Orchard Ste 145
Lake Forest, CA 92630-8314
Phone
(858) 699-7006
NPI assigned
Mar 3, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH30028 CA Primary

Addresses

Primary practice location

1 Orchard Ste 145
Lake Forest, CA 92630-8314

Mailing address

1 Orchard Ste 145
Lake Forest, CA 92630-8314
Phone (858) 699-7006

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
RPH30028CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1488499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488499200000",
    "number": "1609316009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ORCHARD STE 145",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926308314",
            "telephone_number": "858-699-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ORCHARD STE 145",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926308314",
            "telephone_number": "858-699-7006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENEDETTO",
        "first_name": "GEORGE",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-03",
        "last_updated": "2017-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH30028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2017; 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.