Active NPI
Maria Christine Tanawan San Agustin
- Pharmacist
- City of Industry, CA
National Provider Identifier
1609756881
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 68782
- Practice address
- 16666 E Johnson Dr
City of Industry, CA 91745-2412 - Phone
- (626) 820-5800
- Fax
- (626) 330-7901
- NPI assigned
- Sep 6, 2025
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 68782 | CA | Primary |
Addresses
Primary practice location
16666 E Johnson Dr
City of Industry, CA 91745-2412
Mailing address
985 Evergreen Cir
Covina, CA 91724-3679
Phone (626) 820-5800
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 68782 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1757116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757116800000",
"number": "1609756881",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "985 EVERGREEN CIR",
"city": "COVINA",
"state": "CA",
"postal_code": "917243679",
"telephone_number": "626-820-5800",
"fax_number": "626-330-7901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16666 E JOHNSON DR",
"city": "CITY OF INDUSTRY",
"state": "CA",
"postal_code": "917452412",
"telephone_number": "626-820-5800",
"fax_number": "626-330-7901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAN AGUSTIN",
"first_name": "MARIA CHRISTINE",
"middle_name": "TANAWAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-09-06",
"last_updated": "2025-09-06",
"certification_date": "2025-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "CA",
"license": "68782",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in City of Industry, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.