David Loth

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY54414 Issued in CA

Legal business name

DAVID LOTH

Doing business as

Park Woods Pharmacy

Practice address

1782 W Hammer LN
Stockton, CA 95209-2922

Phone

(669) 999-6870

NPI assigned

Aug 11, 2016

Organization subpart

No

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

Authorized official

Name

David Loth

Title

Owner

Phone

(669) 999-6870

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Park Woods Pharmacy Doing business as

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

{
    "created_epoch": "1470873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474416000000",
    "number": "1487108015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1782 W HAMMER LN",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952092922",
            "telephone_number": "669-999-6870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1782 W HAMMER LN",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952092922",
            "telephone_number": "669-999-6870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID LOTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-11",
        "last_updated": "2016-09-21",
        "status": "A",
        "authorized_official_last_name": "LOTH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "669-999-6870"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY54414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2163597",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Woods Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Crystal Angelina Davenport, ACSW
• Marquita Ann Davenport
• Renee Davenport
• Todd Eldon Davenport, DPT OCS
• David C. Harris, M.D., Inc.
• David W Davidson
• Pamela Marie Davidson
• Jillian Davies
• Mitchell Samuel Davies
• Davinder S. Manak DDS. Incorporation

• Community/Retail Pharmacy in Stockton, CA
• Providers in Stockton, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2016; 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.