Individual provider Active NPI

Camille Espiritu Santo Mallillin

  • Pharmacist
  • Anaheim, CA
National Provider Identifier
1922890672
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH90947 Issued in CA
Practice address
2940 E la Palma Ave
Anaheim, CA 92806-2619
Phone
(714) 238-0010
NPI assigned
May 20, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH90947 CA Primary

Addresses

Primary practice location

2940 E la Palma Ave
Anaheim, CA 92806-2619

Mailing address

12631 Glen St
Garden Grove, CA 92840-5420
Phone (714) 313-4862

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
RPH90947CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1747699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1922890672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12631 GLEN ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928405420",
            "telephone_number": "714-313-4862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 E LA PALMA AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928062619",
            "telephone_number": "714-238-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLILLIN",
        "first_name": "CAMILLE",
        "middle_name": "ESPIRITU SANTO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-20",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH90947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2025; 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.