Active NPI
Kimberly Isabel Garay
- Pharmacist
- Adelanto, CA
National Provider Identifier
1619791753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 90448
- Practice address
- 12058 Palmdale Rd
Adelanto, CA 92301-6708 - Phone
- (760) 246-2803
- NPI assigned
- Nov 14, 2024
- Last updated
- Nov 14, 2024
- Sex
- Female
- Sole proprietor
- No
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 | 90448 | CA | Primary |
Addresses
Primary practice location
12058 Palmdale Rd
Adelanto, CA 92301-6708
Mailing address
12058 Palmdale Rd
Adelanto, CA 92301-6708
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 |
|---|---|---|---|
| 90448 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Longs Drug Stores California, LLC | Past | Accepting new patients | |
| Longs Drug Store California LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba CVS Pharmacy #04291
- Community/Retail Pharmacy
- Adelanto, CA
- NPI 1346323482
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1731542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731542400000",
"number": "1619791753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12058 PALMDALE RD",
"city": "ADELANTO",
"state": "CA",
"postal_code": "923016708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12058 PALMDALE RD",
"city": "ADELANTO",
"state": "CA",
"postal_code": "923016708",
"telephone_number": "760-246-2803"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARAY",
"first_name": "KIMBERLY",
"middle_name": "ISABEL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-14",
"last_updated": "2024-11-14",
"certification_date": "2024-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "90448",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Adelanto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.