Individual provider Active NPI

Robert Dale Hall II, PHARM D.

  • Pharmacist
  • Newport Beach, CA
National Provider Identifier
1689232829
Registry record updated Jun 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
29479 Issued in CA
Practice address
4000 Birch St Ste 120
Newport Beach, CA 92660-2258
Phone
(949) 642-8057
Fax
(949) 642-0725
NPI assigned
Jun 3, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 29479 CA Primary

Addresses

Primary practice location

4000 Birch St Ste 120
Newport Beach, CA 92660-2258

Mailing address

2813 Moose Creek TRL
Suamico, WI 54313-3260
Phone (949) 422-6782

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 Pharmacy

Practice roles

OrganizationSpecialtyStatusNew patients
California Pharmacy & Compounding Center Inc Past Accepting new patients
California Pharmacy & Compounding Center Inc PastSince Oct 6, 2019 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1559520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559520000000",
    "number": "1689232829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2813 MOOSE CREEK TRL",
            "city": "SUAMICO",
            "state": "WI",
            "postal_code": "543133260",
            "telephone_number": "949-422-6782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 BIRCH ST STE 120",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602258",
            "telephone_number": "949-642-8057",
            "fax_number": "949-642-0725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "ROBERT",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "PHARM D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-03",
        "last_updated": "2019-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "29479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2019; 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.