Active NPI
Ericson C. Ganotisi, PHARM.D.
- Pharmacist
- Vacaville, CA
National Provider Identifier
1932659133
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 74303
- Practice address
- 941 Alamo Dr
Vacaville, CA 95687-5601 - Phone
- (707) 359-3183
- Fax
- (707) 359-3184
- NPI assigned
- Oct 11, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 74303 | CA | Primary |
| Pharmacist | 183500000X | 3881 | HI |
Addresses
Primary practice location
941 Alamo Dr
Vacaville, CA 95687-5601
Mailing address
941 Alamo Dr
Vacaville, CA 95687-5601
Phone (707) 359-3183
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 |
|---|---|---|---|
| 74303 | CA | MD | Pharmacist |
| 3881 | HI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walmart Inc. | Past | Accepting new patients | |
| Walmart Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476144000000",
"number": "1932659133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "941 ALAMO DR",
"city": "VACAVILLE",
"state": "CA",
"postal_code": "956875601",
"telephone_number": "707-359-3183",
"fax_number": "707-359-3184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "941 ALAMO DR",
"city": "VACAVILLE",
"state": "CA",
"postal_code": "956875601",
"telephone_number": "707-359-3183",
"fax_number": "707-359-3184"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANOTISI",
"first_name": "ERICSON",
"middle_name": "C.",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-10-11",
"last_updated": "2016-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "74303",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "HI",
"license": "3881",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vacaville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.