Individual provider Active NPI

Peter L Hackland, RPH PHD

  • Pharmacist
  • Grass Valley, CA
National Provider Identifier
1457679490
Registry record updated May 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
59353 Issued in CA
Practice address
720 Sutton Way
Grass Valley, CA 95945-5393
Phone
(530) 273-6652
Fax
(530) 273-1358
NPI assigned
May 14, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 59353 CA Primary

Addresses

Primary practice location

720 Sutton Way
Grass Valley, CA 95945-5393

Mailing address

720 Sutton Way
Grass Valley, CA 95945-5393
Phone (530) 273-6652

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 Philosophy, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
59353CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1273795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273795200000",
    "number": "1457679490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 SUTTON WAY",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455393",
            "telephone_number": "530-273-6652",
            "fax_number": "530-273-1358"
        },
        {
            "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",
            "fax_number": "530-273-1358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKLAND",
        "first_name": "PETER",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "RPH PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-14",
        "last_updated": "2010-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "59353",
            "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 May 14, 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.