Active NPI
Jeffrey Tatum, PHARMD
- Pharmacist
- Bishop, CA
National Provider Identifier
1760033708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 77816
- Practice address
- 250 N See Vee LN
Bishop, CA 93514-8130 - Phone
- (760) 873-8464
- Fax
- (760) 873-6127
- NPI assigned
- Sep 20, 2019
- Sex
- Male
- Sole proprietor
- No
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 | 77816 | CA | Primary |
Addresses
Primary practice location
250 N See Vee LN
Bishop, CA 93514-8130
Mailing address
250 N See Vee LN
Bishop, CA 93514-8130
Phone (760) 873-8464
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| THP11576F | Medicaid | CA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 77816 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568937600000",
"number": "1760033708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 N SEE VEE LN",
"city": "BISHOP",
"state": "CA",
"postal_code": "935148130",
"telephone_number": "760-873-8464",
"fax_number": "760-873-6127"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 N SEE VEE LN",
"city": "BISHOP",
"state": "CA",
"postal_code": "935148130",
"telephone_number": "760-873-8464",
"fax_number": "760-873-6127"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TATUM",
"first_name": "JEFFREY",
"name_prefix": "Mr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-09-20",
"last_updated": "2019-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "77816",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "THP11576F",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bishop, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.