NPIMap

Individual provider Active NPI

Ryan Patrick Anderson, PHARMD

  • Pharmacist
  • Santee, CA
National Provider Identifier
1629355201
Registry record updated Apr 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
62127 Issued in CA
Practice address
9305 Mission Gorge Rd
Santee, CA 92071-3815
Phone
(619) 258-8011
Fax
(619) 258-8026
NPI assigned
Nov 9, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 62127 CA Primary

Addresses

Primary practice location

9305 Mission Gorge Rd
Santee, CA 92071-3815

Mailing address

9305 Mission Gorge Rd
Santee, CA 92071-3815
Phone (619) 258-8011

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

LicenseStateTypeSpecialty
62127CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co. CurrentSince Apr 9, 2023 Accepting new patients
Walgreen Co PastSince Apr 9, 2023 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1320796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680393600000",
    "number": "1629355201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9305 MISSION GORGE RD",
            "city": "SANTEE",
            "state": "CA",
            "postal_code": "920713815",
            "telephone_number": "619-258-8011",
            "fax_number": "619-258-8026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9305 MISSION GORGE RD",
            "city": "SANTEE",
            "state": "CA",
            "postal_code": "920713815",
            "telephone_number": "619-258-8011",
            "fax_number": "619-258-8026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "RYAN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-09",
        "last_updated": "2023-04-02",
        "certification_date": "2023-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "62127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santee, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2023; 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.