Active NPI
Vippan Mattu
- Pharmacist
- Yuba City, CA
National Provider Identifier
1508311184
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 73796
- Practice address
- 1055 Martin CT
Yuba City, CA 95993-9739 - Phone
- (530) 329-3082
- NPI assigned
- Aug 24, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 | 73796 | CA | Primary |
Addresses
Primary practice location
1055 Martin CT
Yuba City, CA 95993-9739
Mailing address
1624 Danbrook Dr
Sacramento, CA 95835-1611
Phone (530) 675-4258
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582502400000",
"number": "1508311184",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1624 DANBROOK DR",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958351611",
"telephone_number": "530-675-4258"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1055 MARTIN CT",
"city": "YUBA CITY",
"state": "CA",
"postal_code": "959939739",
"telephone_number": "530-329-3082"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTU",
"first_name": "VIPPAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-08-24",
"last_updated": "2020-02-24",
"certification_date": "2020-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "73796",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yuba City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.