Derek Michael Miyasaki, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

64543 Issued in CA

Practice address

1799 Marlow Rd
Santa Rosa, CA 95401-4474

Phone

(707) 528-3396

Fax

(707) 528-0760

NPI assigned

Aug 10, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

Practice roles

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

• Safeway Inc

  • Community/Retail Pharmacy
  • Santa Rosa, CA
  • NPI 1063441004
  NPD (past)

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

{
    "created_epoch": "1312934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482278400000",
    "number": "1659650596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1799 MARLOW RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014474",
            "telephone_number": "707-528-3396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1799 MARLOW RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014474",
            "telephone_number": "707-528-3396",
            "fax_number": "707-528-0760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIYASAKI",
        "first_name": "DEREK",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-10",
        "last_updated": "2016-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "64543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miles F. Mitchell, MD
• Steven A Mitnick, MD
• Anna Yemiz Mitsunaga, PT DPT
• Kathryn Mitts, RN, CDE
• Kelly Miyano, RN
• Heidi Mize
• Deborah J Mizell, LCSW
• Mobility Masters Northern California Inc.
• Modern Sight Optometric Corporation
• Frank Edward Modic, M.D.

• Pharmacist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Pharmacist in California

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