Active NPI
Peewee Del Corro Cruz
- Pharmacist
- Perris, CA
National Provider Identifier
1790092625
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 58307
- Practice address
- 1688 N Perris Blvd
Perris, CA 92571 - Phone
- (951) 943-6868
- NPI assigned
- Sep 14, 2010
- Last updated
- Sep 14, 2010
- Sex
- Female
- 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 | 58307 | CA | Primary |
Addresses
Primary practice location
1688 N Perris Blvd
Perris, CA 92571
Mailing address
35434 Saddle Hill Rd
Lake Elsinore, CA 92532-2589
Phone (805) 512-1173
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 |
|---|---|---|---|
| 58307 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284422400000",
"number": "1790092625",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35434 SADDLE HILL RD",
"city": "LAKE ELSINORE",
"state": "CA",
"postal_code": "925322589",
"telephone_number": "805-512-1173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1688 N PERRIS BLVD",
"city": "PERRIS",
"state": "CA",
"postal_code": "92571",
"telephone_number": "951-943-6868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUZ",
"first_name": "PEEWEE",
"middle_name": "DEL CORRO",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-14",
"last_updated": "2010-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "58307",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Perris, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.