Individual provider Active NPI

Bryan Porterfield, PHARMD

  • Pharmacist
  • San Diego, CA
National Provider Identifier
1962744383
Registry record updated Mar 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
68697 Issued in CA
Practice address
6623 Montezuma Rd
Apt 74
San Diego, CA 92115-2838
Phone
(336) 212-0933
NPI assigned
Mar 24, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 68697 CA Primary

Addresses

Primary practice location

6623 Montezuma Rd
Apt 74
San Diego, CA 92115-2838

Mailing address

6623 Montezuma Rd
Apt 74
San Diego, CA 92115-2838
Phone (336) 212-0933

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

LicenseStateTypeSpecialty
68697CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1364083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364083200000",
    "number": "1962744383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6623 MONTEZUMA RD",
            "address_2": "APT 74",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921152838",
            "telephone_number": "336-212-0933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6623 MONTEZUMA RD",
            "address_2": "APT 74",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921152838",
            "telephone_number": "336-212-0933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTERFIELD",
        "first_name": "BRYAN",
        "name_prefix": "Mr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-24",
        "last_updated": "2013-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "68697",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 24, 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.

Verify at the official NPI Registry.