Individual provider Active NPI

John Ergino, PHARMD

  • Pharmacist
  • San Pablo, CA
National Provider Identifier
1770368540
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
88021 Issued in CA
Practice address
15650 San Pablo Ave
San Pablo, CA 94806-1240
Phone
(510) 243-1100
NPI assigned
Aug 29, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 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 88021 CA Primary

Addresses

Primary practice location

15650 San Pablo Ave
San Pablo, CA 94806-1240

Mailing address

4949 Church St
Skokie, IL 60077-1294

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
88021CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co PastSince Sep 5, 2023 Accepting new patients
Walgreen Co PastSince Sep 5, 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": "1693267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1770368540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4949 CHURCH ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15650 SAN PABLO AVE",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948061240",
            "telephone_number": "510-243-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERGINO",
        "first_name": "JOHN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-29",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "88021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pablo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.