Active NPI
Virgil Baldivino Cubacha
- Pharmacist
- Fresno, CA
National Provider Identifier
1942794110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 75024
- Practice address
- 3680 W Shaw Ave
Fresno, CA 93711-3231 - Phone
- (559) 277-8191
- NPI assigned
- Jun 20, 2018
- 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 | 75024 | CA | Primary |
Addresses
Primary practice location
3680 W Shaw Ave
Fresno, CA 93711-3231
Mailing address
1865 Herndon Ave # K55
Clovis, CA 93611-6163
Phone (562) 760-3578
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 |
|---|---|---|---|
| 75024 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529452800000",
"number": "1942794110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1865 HERNDON AVE # K55",
"city": "CLOVIS",
"state": "CA",
"postal_code": "936116163",
"telephone_number": "562-760-3578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3680 W SHAW AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937113231",
"telephone_number": "559-277-8191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUBACHA",
"first_name": "VIRGIL",
"middle_name": "BALDIVINO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-06-20",
"last_updated": "2018-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "75024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.