Individual provider Active NPI

Edric Oduca

  • Pharmacist
  • Chino Hills, CA
National Provider Identifier
1821581380
Registry record updated Jun 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
77282 Issued in CA
Practice address
2396 Brookhaven Dr
Chino Hills, CA 91709-1734
Phone
(909) 573-6766
NPI assigned
Jun 10, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 77282 CA Primary

Addresses

Primary practice location

2396 Brookhaven Dr
Chino Hills, CA 91709-1734

Mailing address

2396 Brookhaven Dr
Chino Hills, CA 91709-1734

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

LicenseStateTypeSpecialty
77282CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1528588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528588800000",
    "number": "1821581380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2396 BROOKHAVEN DR",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917091734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2396 BROOKHAVEN DR",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917091734",
            "telephone_number": "909-573-6766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODUCA",
        "first_name": "EDRIC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-10",
        "last_updated": "2018-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "77282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2018; 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.