Individual provider Active NPI

Mariaruby Vitor, RPH

  • Pharmacist
  • Sylmar, CA
National Provider Identifier
1689047953
Registry record updated Nov 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
52955 Issued in CA
Practice address
12717 Glenoaks Blvd
Sylmar, CA 91342-4749
Phone
(818) 367-6116
Fax
(818) 364-6712
NPI assigned
Nov 9, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 52955 CA Primary

Addresses

Primary practice location

12717 Glenoaks Blvd
Sylmar, CA 91342-4749

Mailing address

12717 Glenoaks Blvd
Sylmar, CA 91342-4749
Phone (818) 367-6116

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

LicenseStateTypeSpecialty
52955CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1447027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447027200000",
    "number": "1689047953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12717 GLENOAKS BLVD",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913424749",
            "telephone_number": "818-367-6116",
            "fax_number": "818-364-6712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12717 GLENOAKS BLVD",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913424749",
            "telephone_number": "818-367-6116",
            "fax_number": "818-364-6712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITOR",
        "first_name": "MARIARUBY",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-09",
        "last_updated": "2015-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "52955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylmar, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2015; 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.