Active NPI
Henry A Gotterer, PHARMD
- Pharmacist
- Garden Grove, CA
National Provider Identifier
1073667473
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 27855
- Practice address
- 12665 Garden Grove Blvd
#108
Garden Grove, CA 92843-1901 - Phone
- (714) 530-1130
- Fax
- (714) 537-7736
- NPI assigned
- Jan 22, 2007
- 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 | 27855 | CA | Primary |
Addresses
Primary practice location
12665 Garden Grove Blvd
#108
Garden Grove, CA 92843-1901
Mailing address
12071 Marquis Cir
Santa Ana, CA 92705-2947
Phone (714) 832-2887
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 |
|---|---|---|---|
| 27855 | CA | MD | Clinical Social Worker |
Interoperability endpoints
- https://api.platform.athenahealth.com/12915/brand/1/csg/1/fhir/r4
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073667473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12071 MARQUIS CIR",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927052947",
"telephone_number": "714-832-2887",
"fax_number": "714-832-6197"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12665 GARDEN GROVE BLVD",
"address_2": "#108",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928431901",
"telephone_number": "714-530-1130",
"fax_number": "714-537-7736"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOTTERER",
"first_name": "HENRY",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "27855",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garden Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.