Individual provider Active NPI

Romualdo Kamantigue Aquino

  • Pharmacist
  • Visalia, CA
National Provider Identifier
1710692231
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
87630 Issued in CA
Practice address
1102 N Demaree St
Visalia, CA 93291-7701
Phone
(559) 738-8629
NPI assigned
Jan 19, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 87630 CA Primary

Addresses

Primary practice location

1102 N Demaree St
Visalia, CA 93291-7701

Mailing address

7166 N Fruit Ave Apt 150
Fresno, CA 93711-0752

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
87630CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Garfield Beach CVS, L.L.C. PastSince Jan 22, 2023 Accepting new patients
Garfield Beach CVS LLC PastSince Jan 22, 2023 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": "1674086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1710692231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7166 N FRUIT AVE APT 150",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937110752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 N DEMAREE ST",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932917701",
            "telephone_number": "559-738-8629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AQUINO",
        "first_name": "ROMUALDO",
        "middle_name": "KAMANTIGUE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-19",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "87630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; 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.