Ivan Michael Desantis, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

43890 Issued in CA

Practice address

2231 Douglas Blvd Ste 100
Roseville, CA 95661-4264

Phone

(916) 244-2085

NPI assigned

Jun 24, 2024

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

Registered Pharmacist

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

{
    "created_epoch": "1719187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1740024603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4455 CONNECTICUT AVE NW APT 605",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200082338",
            "telephone_number": "323-529-4047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2231 DOUGLAS BLVD STE 100",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614264",
            "telephone_number": "916-244-2085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESANTIS",
        "first_name": "IVAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-24",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "43890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paige M Denorme
• Dental Corporation of Charles Rodgers and Carolyn Ghazal (Pavilions Dental Group)
• Rupinder M Deol, ARNP
• Asha Kaushik Desai, M.D.
• Sundeep H Desai, M.D.
• Kenya Desautels, CPO
• Steven D Descoteaux, M.D.
• Cynthia A. Descovich, MA
• Karen Anne Dettman, M.S., CCC-A
• Vivian Naomi Devai, OTR/L

• Pharmacist in Roseville, CA
• Providers in Roseville, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; 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.