Individual provider Active NPI

Maereg K Woldekiros, PHARMD

  • Pharmacist
  • San Diego, CA
National Provider Identifier
1780303909
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
86526 Issued in CA
Practice address
8793 Lightwave Ave Apt 220
San Diego, CA 92123-5008
Phone
(206) 529-7835
NPI assigned
Aug 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 86526 CA Primary

Addresses

Primary practice location

8793 Lightwave Ave Apt 220
San Diego, CA 92123-5008

Mailing address

8793 Lightwave Ave Apt 220
San Diego, CA 92123-5008

Other practice location 1

200 W Arbor Dr Fl 1
San Diego, CA 92103-1911
Phone (619) 543-3279

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

NPI Registry JSON

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

{
    "created_epoch": "1661126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1780303909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8793 LIGHTWAVE AVE APT 220",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921235008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8793 LIGHTWAVE AVE APT 220",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921235008",
            "telephone_number": "206-529-7835"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 W Arbor Dr Fl 1",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921031911",
            "country_code": "US",
            "telephone_number": "619-543-3279",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLDEKIROS",
        "first_name": "MAEREG",
        "middle_name": "K",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "86526",
            "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 Aug 22, 2022; 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.