Active NPI
Kyle Ota
- Pharmacist
- San Diego, CA
National Provider Identifier
1730936030
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 89474
- Practice address
- 3081B Clairemont Dr
San Diego, CA 92117-6802 - Phone
- (619) 275-1175
- NPI assigned
- May 3, 2024
- Last updated
- May 3, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 89474 | CA | Primary |
Addresses
Primary practice location
3081B Clairemont Dr
San Diego, CA 92117-6802
Mailing address
199 Castillon Way
San Jose, CA 95119-1502
Phone (408) 239-7232
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
| License | State | Type | Specialty |
|---|---|---|---|
| 89474 | CA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1714694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714694400000",
"number": "1730936030",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "199 CASTILLON WAY",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951191502",
"telephone_number": "408-239-7232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3081B CLAIREMONT DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921176802",
"telephone_number": "619-275-1175"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OTA",
"first_name": "KYLE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-05-03",
"last_updated": "2024-05-03",
"certification_date": "2024-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "89474",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.