Individual provider Active NPI

Maximilian A. Schanderl, PHARM.D.

  • Pharmacist
  • Waterford, CA
National Provider Identifier
1336176122
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH37119 Issued in CA
Practice address
12641 Bentley St
Waterford, CA 95386-9011
Phone
(209) 874-2138
Fax
(209) 874-9853
NPI assigned
Jun 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 RPH37119 CA Primary

Addresses

Primary practice location

12641 Bentley St
Waterford, CA 95386-9011

Mailing address

PO Box 196
Waterford, CA 95386-0196
Phone (209) 874-2138

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
RPH37119CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Tower Pharmacy, Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336176122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 196",
            "city": "WATERFORD",
            "state": "CA",
            "postal_code": "953860196",
            "telephone_number": "209-874-2138",
            "fax_number": "209-874-9853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12641 BENTLEY ST",
            "city": "WATERFORD",
            "state": "CA",
            "postal_code": "953869011",
            "telephone_number": "209-874-2138",
            "fax_number": "209-874-9853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHANDERL",
        "first_name": "MAXIMILIAN",
        "middle_name": "A.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH37119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, 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.

Verify at the official NPI Registry.