Individual provider Active NPI

Elaine H. Der, PHARM.D.

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • San Fernando, CA
National Provider Identifier
1386948636
Registry record updated Dec 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
47431 Issued in CA
Practice address
732 Mott St
Suite 150
San Fernando, CA 91340-4237
Phone
(818) 837-3775
Fax
(818) 837-3799
NPI assigned
Dec 30, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 47431 CA Primary

Addresses

Primary practice location

732 Mott St
Suite 150
San Fernando, CA 91340-4237

Mailing address

732 Mott St
Suite 150
San Fernando, CA 91340-4237
Phone (818) 837-3775

Other names 1

  • Dr. Elaine H. Der Professional name

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
47431CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1293667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293667200000",
    "number": "1386948636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "732 MOTT ST",
            "address_2": "SUITE 150",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913404237",
            "telephone_number": "818-837-3775",
            "fax_number": "818-837-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "732 MOTT ST",
            "address_2": "SUITE 150",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913404237",
            "telephone_number": "818-837-3775",
            "fax_number": "818-837-3799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DER",
        "first_name": "ELAINE",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-30",
        "last_updated": "2010-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "CA",
            "license": "47431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELAINE",
            "last_name": "DER",
            "middle_name": "H.",
            "prefix": "DR.",
            "credential": "PHARM.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in San Fernando, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.

Verify at the official NPI Registry.