Individual provider Active NPI

Ivan Derek Du Preez, RPH

  • Pharmacist
  • Palm Springs, CA
National Provider Identifier
1154829190
Registry record updated Jan 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
58215 Issued in CA
Practice address
5601 E Ramon Rd
Palm Springs, CA 92264-3605
Phone
(760) 322-3906
NPI assigned
Jan 24, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 58215 CA Primary

Addresses

Primary practice location

5601 E Ramon Rd
Palm Springs, CA 92264-3605

Mailing address

46422 Bradshaw TRL
La Quinta, CA 92253-2353
Phone (760) 699-3726

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
58215CAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1516752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516752000000",
    "number": "1154829190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46422 BRADSHAW TRL",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922532353",
            "telephone_number": "760-699-3726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 E RAMON RD",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922643605",
            "telephone_number": "760-322-3906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DU PREEZ",
        "first_name": "IVAN",
        "middle_name": "DEREK",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-24",
        "last_updated": "2018-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "58215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2018; 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.