Active NPI
Roberto Datiles, RPH
- Pharmacist
- El Cajon, CA
National Provider Identifier
1659795342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 66710
- Practice address
- 215 N 2ND St
El Cajon, CA 92021-7243 - Phone
- (619) 401-0761
- NPI assigned
- Feb 14, 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH60120621 | WA | |
| Geriatric Pharmacist | 1835G0303X | 66710 | CA | |
| Pharmacist | 183500000X | 66710 | CA | Primary |
Addresses
Primary practice location
215 N 2ND St
El Cajon, CA 92021-7243
Mailing address
7865 Starling Dr
San Diego, CA 92123-2747
Phone (619) 665-9271
Other practice location 1
100 N Imperial Ave
El Centro, CA 92243-2809
Phone (760) 335-4904
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 |
|---|---|---|---|
| PH60120621 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585958400000",
"number": "1659795342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7865 STARLING DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921232747",
"telephone_number": "619-665-9271"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 N 2ND ST",
"city": "EL CAJON",
"state": "CA",
"postal_code": "920217243",
"telephone_number": "619-401-0761"
}
],
"practiceLocations": [
{
"address_1": "100 N Imperial Ave",
"address_purpose": "LOCATION",
"city": "El Centro",
"state": "CA",
"postal_code": "922432809",
"country_code": "US",
"telephone_number": "760-335-4904",
"fax_number": "760-768-4262",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DATILES",
"first_name": "ROBERTO",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-02-14",
"last_updated": "2020-04-04",
"certification_date": "2020-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH60120621",
"primary": false
},
{
"code": "1835G0303X",
"taxonomy_group": "",
"desc": "Pharmacist, Geriatric",
"state": "CA",
"license": "66710",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "66710",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Cajon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.