Active NPI
Nhak Devean Vann
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Calimesa, CA
National Provider Identifier
1659656726
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 57857
- Practice address
- 1186 Calimesa Blvd
Calimesa, CA 92320-1509 - Phone
- (909) 795-1147
- NPI assigned
- Oct 19, 2011
- Last updated
- Oct 19, 2011
- 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 Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 57857 | CA | Primary |
Addresses
Primary practice location
1186 Calimesa Blvd
Calimesa, CA 92320-1509
Mailing address
1186 Calimesa Blvd
Calimesa, CA 92320-1509
Phone (909) 795-1147
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 57857 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318982400000",
"number": "1659656726",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1186 CALIMESA BLVD",
"city": "CALIMESA",
"state": "CA",
"postal_code": "923201509",
"telephone_number": "909-795-1147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1186 CALIMESA BLVD",
"city": "CALIMESA",
"state": "CA",
"postal_code": "923201509",
"telephone_number": "909-795-1147"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANN",
"first_name": "NHAK",
"middle_name": "DEVEAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-10-19",
"last_updated": "2011-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "CA",
"license": "57857",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Calimesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.