Active NPI
Tonie Iwu
- Pharmacist
- Tracy, CA
National Provider Identifier
1811575699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 82702
- Practice address
- 3010 W Grant Line Rd
Tracy, CA 95304-9402 - Phone
- (209) 836-5786
- NPI assigned
- Apr 1, 2021
- 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 | 82702 | CA | Primary |
Addresses
Primary practice location
3010 W Grant Line Rd
Tracy, CA 95304-9402
Mailing address
565 W Corazon Way
Mountain House, CA 95391-2050
Phone (510) 754-3476
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 |
|---|---|---|---|
| 82702 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617235200000",
"number": "1811575699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "565 W CORAZON WAY",
"city": "MOUNTAIN HOUSE",
"state": "CA",
"postal_code": "953912050",
"telephone_number": "510-754-3476"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3010 W GRANT LINE RD",
"city": "TRACY",
"state": "CA",
"postal_code": "953049402",
"telephone_number": "209-836-5786"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IWU",
"first_name": "TONIE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-01",
"last_updated": "2021-04-01",
"certification_date": "2021-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "82702",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tracy, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.