Cabrillo Pharmacy, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

CABRILLO PHARMACY, INC.

Practice address

146 N Brent St
Ventura, CA 93003-2810

Phone

(805) 643-9939

Fax

(805) 643-9342

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Robert Thomas Leark

Title

President

Phone

(805) 498-6615

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Cabrillo Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sandra Aggarwal, RPH

  • Pharmacist
  • Ventura, CA
  • NPI 1043788474
  NPD (past)
• Robert Louis Blomquist, RPH

  • Pharmacist
  • Ventura, CA
  • NPI 1356439418
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561507200000",
    "number": "1679685663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 N BRENT ST",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930032810",
            "telephone_number": "805-643-9939",
            "fax_number": "805-643-9342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 N BRENT ST",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930032810",
            "telephone_number": "805-643-9939",
            "fax_number": "805-643-9342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CABRILLO PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2019-06-26",
        "status": "A",
        "authorized_official_last_name": "LEARK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-498-6615"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2115771",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cabrillo Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marisela Cabral-Centeno, MSW
• Christina Nicole Cabral
• Marina Victoria Cabrera, LVN
• Roni M Cabrera, RN
• Cabrillo Pharmacy
• Lilliana Olivia Cachu
• Crystal Caffee, LVN
• Ian Patrick Cahatol, DO
• Cathy Jayne Cajucom
• Brenna Calabrese, FNP

• All providers in Ventura, CA
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.