Individual provider Active NPI

Derek Terada, PHARMD

  • Pharmacist
  • Trabuco Canyon, CA
National Provider Identifier
1871006544
Registry record updated Nov 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH38236 Issued in CA
Practice address
35 Golf View Dr
Trabuco Canyon, CA 92679-3802
Phone
(949) 981-7788
NPI assigned
Nov 15, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH38236 CA Primary

Addresses

Primary practice location

35 Golf View Dr
Trabuco Canyon, CA 92679-3802

Mailing address

35 Golf View Dr
Trabuco Canyon, CA 92679-3802

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

LicenseStateTypeSpecialty
RPH38236CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1510704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510704000000",
    "number": "1871006544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 GOLF VIEW DR",
            "city": "TRABUCO CANYON",
            "state": "CA",
            "postal_code": "926793802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 GOLF VIEW DR",
            "city": "TRABUCO CANYON",
            "state": "CA",
            "postal_code": "926793802",
            "telephone_number": "949-981-7788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERADA",
        "first_name": "DEREK",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-15",
        "last_updated": "2017-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH38236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trabuco Canyon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2017; 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.