Individual provider Active NPI

Ryan Angel Diaz, PHARMACY TECHNICIAN

  • Pharmacy Technician
  • Fontana, CA
National Provider Identifier
1689331340
Registry record updated Nov 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacy TechnicianTaxonomy code 183700000X
License
99278 Issued in CA
Practice address
16910 Foothill Blvd
Fontana, CA 92335-3502
Phone
(909) 350-0493
Fax
(909) 350-2025
NPI assigned
Nov 17, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X 99278 CA Primary

Addresses

Primary practice location

16910 Foothill Blvd
Fontana, CA 92335-3502

Mailing address

9104 Palm LN
Fontana, CA 92335-5197
Phone (909) 486-9564

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
99278CAMDPharmacy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Thrifty Payless Inc PastSince Nov 21, 2021 Accepting new patients
Thrifty Payless Inc PastSince Nov 21, 2021 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1637107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1689331340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9104 PALM LN",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923355197",
            "telephone_number": "909-486-9564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16910 FOOTHILL BLVD",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923353502",
            "telephone_number": "909-350-0493",
            "fax_number": "909-350-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "RYAN",
        "middle_name": "ANGEL",
        "credential": "PHARMACY TECHNICIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-17",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "CA",
            "license": "99278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; 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.