Victor John Stathis, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

RPH37612 Issued in CA

Practice address

4994 Joe Howard Street
Mariposa, CA 95338

Phone

(209) 742-5600

Fax

(209) 742-7500

NPI assigned

Apr 1, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1301616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301616000000",
    "number": "1861781601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4994 JOE HOWARD STREET",
            "city": "MARIPOSA",
            "state": "CA",
            "postal_code": "95338",
            "telephone_number": "209-742-5600",
            "fax_number": "209-742-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4994 JOE HOWARD STREET",
            "city": "MARIPOSA",
            "state": "CA",
            "postal_code": "95338",
            "telephone_number": "209-742-5600",
            "fax_number": "209-742-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATHIS",
        "first_name": "VICTOR",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-01",
        "last_updated": "2011-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH37612",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S012735",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Mariposa, CA
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.

Verify at the official NPI Registry.