MR. JERALD DAVID ROBERTSON (NPI# 1578691572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578691572 |
| Entity Type | Individual |
| Full Name | MR. JERALD DAVID ROBERTSON |
| Other Name | MR. JERRY DAVID ROBERTSON |
| Credential | R.PH. |
| Practice Address |
1500 Whitley Ave Corcoran CA 93212-2226 |
| Mailing Address |
2331 Whitley Ave Corcoran CA 93212-2023 |
| Practice Telephone | 5599928020 |
| Practice Fax Number | 5599923881 |
| Mailing Telephone | 5599923762 |
| Mailing Fax Number | 5599923762 |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 27509 | CA | Pharmacy Service Providers |
| Street Address |
1500 WHITLEY AVE |
| City | CORCORAN |
| State | CA |
| Zip Code | 93212-2226 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184915357 | Robert M. Alcorn | Pharmacist | 1500 Whitley Ave, Corcoran, CA 93212-2226 | 2011-04-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841746583 | Luis Alvarez | Specialist/Technologist | 1000 Alder Ave, Corcoran, CA 93212 | 2016-09-01 |
| 1881893667 | William Joseph Mcguinness | Internal Medicine | 4001 W. King Ave, Corcoran, CA 93212 | 2007-07-12 |
| 1265576912 | Kings View Counseling Services for Kings Count | Community/Behavioral Health | 1002 Dairy Avenue, Corcoran, CA 93212 | 2007-02-16 |
| 1255480406 | John Vernon Dale Richardson | Dentist | 1409 Whitley Ave, Suite D, Corcoran, CA 93212 | 2007-01-09 |
| 1093748923 | Michael Alan Ross | Physician Assistant | 900 Quebec, Corcoran, CA 93212 | 2006-07-07 |
| 1407460454 | Tiffany Jean Sparks-mendoza | Social Worker | 4001 King Ave., Corcoran, CA 93212 | 2020-09-06 |
| 1376190876 | Corrections and Rehabilitation | Pharmacy | 4001 King Avenue, Corcoran, CA 93212 | 2019-08-20 |
| 1639507825 | Benjamin J Adam | Psychologist | 4001 King Ave, Corcoran, CA 93212 | 2013-10-24 |
| 1427317700 | Carolyn Virginia Bola | Psychologist | 4001 King Ave, Corcoran, CA 93212 | 2012-05-08 |
| 1629379367 | Rachel Simmi Jerdin | Social Worker | 900 Quebec Ave, Corcoran, CA 93212 | 2010-11-11 |
| Find all providers in zip 93212 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013944677 | Sean Otto Kane | Pharmacist | 4001 King Ave, Corcoran, CA 93212-9611 | 2006-06-27 |
| 1578174793 | Frank Lac Nguyen | Pharmacist | 1115 Whitley Ave, Corcoran, CA 93212-2325 | 2020-08-11 |
| 1669083028 | Seulji Chang | Pharmacist | 1115 Whitley Ave, Corcoran, CA 93212-2325 | 2020-08-11 |
| 1245691294 | Mimose Zephir | Pharmacist | 900 Quebec Ave, Corcoran, CA 93212-9715 | 2016-03-17 |
| 1295193621 | Darin Anderson | Pharmacist | 900 Quebec Ave, Corcoran, CA 93212-9715 | 2016-01-30 |
| 1093115990 | Dana Darling | Pharmacist | 4001 King Ave, Corcoran, CA 93212-9611 | 2014-08-27 |
| 1225447675 | Tom Richard Dirkovich | Pharmacist | 4001 King Ave, Corcoran, CA 93212-9611 | 2014-08-11 |
| 1770913394 | Keithlyn Richards | Pharmacist | 900 Quebec Ave, Corcoran, CA 93212-9715 | 2013-11-18 |
| 1538420732 | Thu Hang Thi Ngo | Pharmacist | 900 Quebec Ave, Corcoran, CA 93212-9715 | 2012-06-04 |
| 1104187616 | Stephen Dale Bartlett | Pharmacist | 900 Quebec Ave, Corcoran, CA 93212-9715 | 2012-05-31 |
| Find all providers in CORCORAN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.