Danilo Santiago Dela Cruz
Individual provider Active NPI Pharmacist · Fortuna, CA
NPI 1992087050 · NPPES record last updated Sep 14, 2011
Key facts
- NPI
- 1992087050
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RPH 60891 (CA)
- Practice address
- 1065 S Fortuna Blvd
Fortuna, CA 95540-3010 - Phone
- (707) 726-0377
- NPI assigned
- Sep 14, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH 60891 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH 60891 | CA | Yes |
Addresses
Primary practice location
1065 S Fortuna Blvd
Fortuna, CA 95540-3010
Mailing address
833 Springville Ave
Fortuna, CA 95540-2887
Phone (707) 386-5581
Other providers in Fortuna, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 14, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.