Active NPI
Brian Eugene Cobb, RPH
- Pharmacist
- Valley Springs, CA
National Provider Identifier
1649677741
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 62025
- Practice address
- 1906 Vista del Lago Dr
Suite G.
Valley Springs, CA 95252-9700 - Phone
- (209) 980-3299
- Fax
- (209) 920-3391
- NPI assigned
- Dec 4, 2014
- Sex
- Male
- 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 | 62025 | CA | Primary |
Addresses
Primary practice location
1906 Vista del Lago Dr
Suite G.
Valley Springs, CA 95252-9700
Mailing address
1906 Vista del Lago Dr
Suite G.
Valley Springs, CA 95252-9700
Phone (209) 980-3299
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
| License | State | Type | Specialty |
|---|---|---|---|
| 62025 | CA | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1417651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417651200000",
"number": "1649677741",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1906 VISTA DEL LAGO DR",
"address_2": "SUITE G.",
"city": "VALLEY SPRINGS",
"state": "CA",
"postal_code": "952529700",
"telephone_number": "209-980-3299",
"fax_number": "209-920-3391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1906 VISTA DEL LAGO DR",
"address_2": "SUITE G.",
"city": "VALLEY SPRINGS",
"state": "CA",
"postal_code": "952529700",
"telephone_number": "209-980-3299",
"fax_number": "209-920-3391"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COBB",
"first_name": "BRIAN",
"middle_name": "EUGENE",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-12-04",
"last_updated": "2014-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "62025",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Valley Springs, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.