Individual provider Active NPI

Rodelle Sacman

  • Pharmacist
  • La Mesa, CA
National Provider Identifier
1629793732
Registry record updated Feb 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
87094 Issued in CA
Practice address
7200 Parkway Dr Ste 104
La Mesa, CA 91942-1534
Phone
(858) 722-1832
NPI assigned
Oct 11, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 87094 CA Primary

Addresses

Primary practice location

7200 Parkway Dr Ste 104
La Mesa, CA 91942-1534

Mailing address

10234 Kibler Dr
San Diego, CA 92126-3539
Phone (858) 722-1832

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

LicenseStateTypeSpecialty
87094CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1665446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740268800000",
    "number": "1629793732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10234 KIBLER DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921263539",
            "telephone_number": "858-722-1832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 PARKWAY DR STE 104",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919421534",
            "telephone_number": "858-722-1832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACMAN",
        "first_name": "RODELLE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-11",
        "last_updated": "2025-02-23",
        "certification_date": "2025-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "87094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.

Verify at the official NPI Registry.