Active NPI
Lydia Anna Bray
- Pharmacist
- Tustin, CA
National Provider Identifier
1881129229
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 031054
- Practice address
- 2102 Seminole
Tustin, CA 92782 - Phone
- (949) 888-3050
- Fax
- (949) 888-3075
- NPI assigned
- Apr 24, 2017
- Sex
- Female
- 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 | 031054 | CA | Primary |
Addresses
Primary practice location
2102 Seminole
Tustin, CA 92782
Mailing address
23361 Antonio Parkway #E
Rancho Santa Margarita, CA 92688
Phone (949) 888-3050
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 |
|---|---|---|---|
| 031054 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492992000000",
"number": "1881129229",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23361 ANTONIO PARKWAY #E",
"city": "RANCHO SANTA MARGARITA",
"state": "CA",
"postal_code": "92688",
"telephone_number": "949-888-3050",
"fax_number": "949-888-3075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2102 SEMINOLE",
"city": "TUSTIN",
"state": "CA",
"postal_code": "92782",
"telephone_number": "949-888-3050",
"fax_number": "949-888-3075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAY",
"first_name": "LYDIA",
"middle_name": "ANNA",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-04-24",
"last_updated": "2017-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "031054",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tustin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.