Active NPI
Russell Tett, PHARMD
- Pharmacist
- San Diego, CA
National Provider Identifier
1881066181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 65348
- Practice address
- 3151 University Ave
San Diego, CA 92104-2039 - Phone
- (619) 283-7366
- Fax
- (619) 283-4485
- NPI assigned
- Oct 26, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 | 65348 | CA | Primary |
Addresses
Primary practice location
3151 University Ave
San Diego, CA 92104-2039
Mailing address
3151 University Ave
San Diego, CA 92104-2039
Phone (619) 283-7366
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 65348 | Other | CA | PHARMACY LICENSE # |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Garfield Beach CVS LLC | Past | Accepting new patients | |
| Garfield Beach CVS, L.L.C. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445817600000",
"number": "1881066181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3151 UNIVERSITY AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921042039",
"telephone_number": "619-283-7366",
"fax_number": "619-283-4485"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3151 UNIVERSITY AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921042039",
"telephone_number": "619-283-7366",
"fax_number": "619-283-4485"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TETT",
"first_name": "RUSSELL",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-10-26",
"last_updated": "2015-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "65348",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY LICENSE #",
"identifier": "65348",
"state": "CA"
}
],
"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 Oct 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.