Active NPI
Cody Luallen, PHARM.D
- Pharmacist
- Hanford, CA
National Provider Identifier
1265060982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 81737
- Practice address
- 115 Mall Dr
Hanford, CA 93230-5786 - Phone
- (559) 582-9000
- NPI assigned
- Mar 29, 2020
- 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 | 81737 | CA | Primary |
Addresses
Primary practice location
115 Mall Dr
Hanford, CA 93230-5786
Mailing address
1360 S Rio Vista Ave
Sanger, CA 93657-9543
Phone (559) 977-7614
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 81737 | Other | CA | CALIFORNIA BOARD OF PHARMACY |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585440000000",
"number": "1265060982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1360 S RIO VISTA AVE",
"city": "SANGER",
"state": "CA",
"postal_code": "936579543",
"telephone_number": "559-977-7614"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 MALL DR",
"city": "HANFORD",
"state": "CA",
"postal_code": "932305786",
"telephone_number": "559-582-9000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUALLEN",
"first_name": "CODY",
"name_prefix": "Dr.",
"credential": "PHARM.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-29",
"last_updated": "2020-03-29",
"certification_date": "2020-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "81737",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA BOARD OF PHARMACY",
"identifier": "81737",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hanford, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.