Active NPI
Marie Dolores San Roman, PHARMD
- Pharmacist
- Banning, CA
National Provider Identifier
1861747172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 68436
- Practice address
- 600 N Highland Springs Ave
Banning, CA 92220-3046 - Phone
- (951) 769-4888
- NPI assigned
- Jul 24, 2012
- Last updated
- Oct 8, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 056900 | NY | |
| Pharmacist | 183500000X | 68436 | CA | Primary |
Addresses
Primary practice location
600 N Highland Springs Ave
Banning, CA 92220-3046
Mailing address
600 N Highland Springs Ave
Banning, CA 92220-3046
Phone (951) 769-4888
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
| License | State | Type | Specialty |
|---|---|---|---|
| 056900 | NY | MD | Dentist |
| 68436 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1381190400000",
"number": "1861747172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 N HIGHLAND SPRINGS AVE",
"city": "BANNING",
"state": "CA",
"postal_code": "922203046",
"telephone_number": "951-769-4888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 N HIGHLAND SPRINGS AVE",
"city": "BANNING",
"state": "CA",
"postal_code": "922203046",
"telephone_number": "951-769-4888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAN ROMAN",
"first_name": "MARIE",
"middle_name": "DOLORES",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-24",
"last_updated": "2013-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "056900",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "68436",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Banning, CA
- San Gorgonio Memorial Health Care District (San Gorgonio Memorial Medical Clinic)
- San Gorgonio Memorial Health Care District
- San Gorgonio Memorial Health Care District
- San Gorgonio Memorial Hospital
- San Gorgonio Memorial Hospital
- Lisa L. Sanborn
- Bianca Sanchez, ASCW
- Juan Francico Sanchez
- Rigel Sanchez, MASSAGE THERAPIST
- Edward Sandoval, AOD COUNSELOR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.