Active NPI
Gavin Hall Kivisto, PHARM.D
- Pharmacist
- Carlsbad, CA
National Provider Identifier
1811273048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 54344
- Practice address
- 6852 Via Verano
Carlsbad, CA 92009-6021 - Phone
- (760) 539-7054
- NPI assigned
- Nov 2, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 54344 | CA | Primary |
| Pharmacist | 183500000X | 12488 | AZ |
Addresses
Primary practice location
6852 Via Verano
Carlsbad, CA 92009-6021
Mailing address
6852 Via Verano
Carlsbad, CA 92009
Phone (760) 539-7054
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 |
|---|---|---|---|
| 12488 | AZ | MD | Clinical Social Worker |
| 54344 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320192000000",
"number": "1811273048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6852 VIA VERANO",
"city": "CARLSBAD",
"state": "CA",
"postal_code": "92009",
"telephone_number": "760-539-7054"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6852 VIA VERANO",
"city": "CARLSBAD",
"state": "CA",
"postal_code": "920096021",
"telephone_number": "760-539-7054"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIVISTO",
"first_name": "GAVIN",
"middle_name": "HALL",
"name_prefix": "Dr.",
"credential": "PHARM.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-11-02",
"last_updated": "2011-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "54344",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "12488",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carlsbad, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.