Active NPI
Robert Williamsen, PHARM.D.
- Pharmacist
- San Bernardino, CA
National Provider Identifier
1972960714
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 39771
- Practice address
- 399 E Highland Ave
Ste 103
San Bernardino, CA 92404-3808 - Phone
- (909) 337-0747
- Fax
- (909) 337-9195
- NPI assigned
- Jan 25, 2016
- Sex
- Male
- Sole proprietor
- No
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 | 39771 | CA | Primary |
Addresses
Primary practice location
399 E Highland Ave
Ste 103
San Bernardino, CA 92404-3808
Mailing address
29099 Hospital Rd
Lake Arrowhead, CA 92352
Phone (909) 337-0747
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
| License | State | Type | Specialty |
|---|---|---|---|
| 39771 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453680000000",
"number": "1972960714",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29099 HOSPITAL RD",
"city": "LAKE ARROWHEAD",
"state": "CA",
"postal_code": "92352",
"telephone_number": "909-337-0747",
"fax_number": "909-337-9195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "399 E HIGHLAND AVE",
"address_2": "STE 103",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924043808",
"telephone_number": "909-337-0747",
"fax_number": "909-337-9195"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMSEN",
"first_name": "ROBERT",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-01-25",
"last_updated": "2016-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "39771",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.