Individual provider Active NPI

Geoffrey Chad Metelak, PHARM D

  • Pharmacist
  • Roseville, CA
National Provider Identifier
1972745503
Registry record updated Mar 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
61963 Issued in CA
Practice address
1600 Eureka Rd
Roseville, CA 95661-3027
Phone
(916) 487-4184
Fax
(916) 784-5434
NPI assigned
Mar 27, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 61963 CA Primary

Addresses

Primary practice location

1600 Eureka Rd
Roseville, CA 95661-3027

Mailing address

2380 Sierra Blvd Apt 18
Sacramento, CA 95825-4718
Phone (805) 797-0610

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

NPI Registry JSON

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

{
    "created_epoch": "1238112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238112000000",
    "number": "1972745503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2380 SIERRA BLVD APT 18",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958254718",
            "telephone_number": "805-797-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 EUREKA RD",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613027",
            "telephone_number": "916-487-4184",
            "fax_number": "916-784-5434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METELAK",
        "first_name": "GEOFFREY",
        "middle_name": "CHAD",
        "name_prefix": "Dr.",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-27",
        "last_updated": "2009-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "61963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2009; 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.