NPI Code Detail JSON Logo

1386230811 NPI number — POLINA YEVGENYEVNA MCDERMOTT PHARMD

NPI Number: 1386230811
Health Care Provider/Practitioner: POLINA YEVGENYEVNA MCDERMOTT PHARMD

Information about “1386230811” NPI (POLINA YEVGENYEVNA MCDERMOTT PHARMD) exists in 1386230811 in HTML format HTML  |  1386230811 in plain Text format TXT  |  1386230811 in PDF (Portable Document Format) PDF  |  1386230811 in an XML format XML  formats.

NPI Number : 1386230811 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1386230811",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MCDERMOTT",
    "FirstName": "POLINA",
    "MiddleName": "YEVGENYEVNA",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "PHARMD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "PULYANINA",
    "OtherFirstName": "POLINA",
    "OtherMiddleName": "YEVGENYEVNA",
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "9 FLICKER DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "NOVATO",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "94949-6621",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "909-360-3752",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "250 BON AIR RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GREENBRAE",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "94904-1702",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "909-360-3752",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/18/2020",
    "LastUpdateDate": "09/07/2021",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "183500000X",
        "TaxonomyName": "Pharmacist",
        "LicenseNumber": "75944",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.