Individual provider Active NPI

Roger S. Klotz, R.PH., BCNSP, FASCP

  • Pharmacotherapy Pharmacist
  • Pomona, CA
National Provider Identifier
1801898069
Registry record updated Aug 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
License
RPH 38533 Issued in CA
Practice address
309 E 2ND St
Pomona, CA 91766-1854
Phone
(714) 974-8858
NPI assigned
Jun 1, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Support Pharmacist 1835N1003X RPH 38533 CA
Pharmacotherapy Pharmacist 1835P1200X RPH 38533 CA Primary
Pharmacist 183500000X RPH 38533 CA

Addresses

Primary practice location

309 E 2ND St
Pomona, CA 91766-1854

Mailing address

PO Box 17265
Anaheim, CA 92817-7265
Phone (714) 998-3807

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
RPH 38533CAMDPharmacotherapy Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282953600000",
    "number": "1801898069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17265",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928177265",
            "telephone_number": "714-998-3807",
            "fax_number": "714-974-8858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 E 2ND ST",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917661854",
            "telephone_number": "714-974-8858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOTZ",
        "first_name": "ROGER",
        "middle_name": "S.",
        "name_prefix": "Mr.",
        "credential": "R.PH., BCNSP, FASCP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2010-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835N1003X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Nutrition Support",
            "state": "CA",
            "license": "RPH 38533",
            "primary": false
        },
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "CA",
            "license": "RPH 38533",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH 38533",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2010; 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.