Individual provider Active NPI

Matthew Wray Stofle, PHARM.D.

  • Pharmacist
  • Anaheim, CA
National Provider Identifier
1174655674
Registry record updated Nov 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH35671 Issued in CA
Practice address
1990 W Crescent Ave
Anaheim, CA 92801-3801
Phone
(800) 879-4644
NPI assigned
Mar 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH35671 CA Primary

Addresses

Primary practice location

1990 W Crescent Ave
Anaheim, CA 92801-3801

Mailing address

15117 Starbuck St
Whittier, CA 90603-2254

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

LicenseStateTypeSpecialty
RPH35671CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1173484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194307200000",
    "number": "1174655674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15117 STARBUCK ST",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906032254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 W CRESCENT AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928013801",
            "telephone_number": "800-879-4644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOFLE",
        "first_name": "MATTHEW",
        "middle_name": "WRAY",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-10",
        "last_updated": "2007-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH35671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.

Verify at the official NPI Registry.