Active NPI
John Patrick Moller, B.PHARM
- Pharmacist
- Grass Valley, CA
National Provider Identifier
1174837223
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 58313
- Practice address
- 720 Sutton Way
Grass Valley, CA 95945-5393 - Phone
- (530) 273-6652
- NPI assigned
- Jul 31, 2010
- 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 | 58313 | CA | Primary |
Addresses
Primary practice location
720 Sutton Way
Grass Valley, CA 95945-5393
Mailing address
1900 Burlin Way
Auburn, CA 95603-5900
Phone (530) 887-8689
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58313 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280534400000",
"number": "1174837223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1900 BURLIN WAY",
"city": "AUBURN",
"state": "CA",
"postal_code": "956035900",
"telephone_number": "530-887-8689"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "720 SUTTON WAY",
"city": "GRASS VALLEY",
"state": "CA",
"postal_code": "959455393",
"telephone_number": "530-273-6652"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOLLER",
"first_name": "JOHN",
"middle_name": "PATRICK",
"credential": "B.PHARM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-07-31",
"last_updated": "2010-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "58313",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grass Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.