MEDPRO PHARMACY INC (NPI# 1639103807) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639103807 |
| Entity Type | Organization |
| Organization Name | MEDPRO PHARMACY INC |
| Other Organization Name | MEDPRO PHARMACY |
| Practice Address |
7129 W Sunset Blvd Los Angeles CA 90046-4411 |
| Practice Telephone | 3239698300 |
| Practice Fax Number | 3239698400 |
| Mailing Telephone | 3239698300 |
| Mailing Fax Number | 3239698400 |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2011-08-30 |
| Authorized Official Name | MR. SIAVASH AHDOOT (PRESIDENT/PHARMACIST) |
| Authorized Official Telephone | 3239398300 |
| Authorized Official Credential | PHARM D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | PHY50438 | CA | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHY50438 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | STATE BOARD OF PHARMACY RETAIL PERMIT | PHY 50438 | 01 |
| CA | 1639103807 | 05 | |
| NCPDP PROVIDER IDENTIFICATION NUMBER | 5622560 | 01 |
| Other Name | Type Code |
|---|---|
| MEDPRO PHARMACY | Doing Business As Name - Organization |
| Street Address |
7129 W SUNSET BLVD |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90046-4411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194325084 | Rimma R Golub | Nurse Practitioner | 948 N. Fairfax Ave, Suite 201, West Hollywood, CA 90046 | 2020-10-29 |
| 1053923607 | Jm Medical Solutions, LLC | Point of Service | 7741 Hollywood Blvd, Los Angeles, CA 90046 | 2020-08-17 |
| 1720592744 | Brian A Torres | Marriage & Family Therapist | 805 North Alta Vista Blvd, Unit 6, Los Angeles, CA 90046 | 2017-11-29 |
| 1770008005 | James N. Orr | Acupuncturist | 1351 N. Crescent Heights Blvd., Suite 116, West Hollywood, CA 90046 | 2017-08-08 |
| 1255701975 | Cameron Lee | Counselor | 8345 Ridpath Drive, Los Angeles, CA 90046 | 2015-10-07 |
| 1720465420 | The Doctor | Internal Medicine | 7531 Santa Monica Blvd Suite 101, West Hollywood, CA 90046 | 2015-05-01 |
| 1497152995 | Lisa Maznio | Counselor | 1400 N Martel Ave Apt 202, Los Angeles, CA 90046 | 2014-11-26 |
| 1013356690 | Pamela Rose Scott | Acupuncturist | 1321 N. Fairfax Ave., #3, West Hollywood, CA 90046 | 2013-06-18 |
| 1720360050 | Paul S. Raine | Marriage & Family Therapist | 8235 Santa Monica Blvd., Suite 400, West Hollywood, CA 90046 | 2011-09-13 |
| 1780995233 | Anna Samsanovich | Registered Nurse | 1701 Camino Palmero, Los Angeles, CA 90046 | 2010-06-30 |
| Find all providers in zip 90046 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265040836 | Cmc Enterprise, Inc. | Pharmacy | 2426 W 8th St Ste 112, Los Angeles, CA 90057-3840 | 2020-07-20 |
| 1538782230 | Altamed Health Services Corp | Pharmacy | 3945 Whittier Blvd Rm 100, Los Angeles, CA 90023-2440 | 2020-05-28 |
| 1184243602 | Dtla Rx Pharmacy Apc | Pharmacy | 1120 S Grand Ave Ste 103, Los Angeles, CA 90015-4677 | 2020-04-14 |
| 1700405701 | Altamed Health Services Corp | Pharmacy | 972 Goodrich Blvd Rm 100, Los Angeles, CA 90022 | 2020-04-10 |
| 1649807140 | Mixlab, Inc. | Pharmacy | 2223 Federal Ave, Los Angeles, CA 90064-1403 | 2020-03-25 |
| 1457985426 | Care Prescription Management | Pharmacy | 5757 Wilshire Blvd Ste 320, Los Angeles, CA 90036-3686 | 2020-02-27 |
| 1609409077 | Altamed Health Services Corp | Pharmacy | 2100 W 3rd St Ste 190, Los Angeles, CA 90057-1999 | 2020-02-13 |
| 1003448184 | Linco Pharmacy, Inc. | Pharmacy | 5755 W Adams Blvd, Los Angeles, CA 90016-2440 | 2020-02-06 |
| 1972149292 | Cedars-sinai Medical Care Foundation | Pharmacy | 11800 Wilshire Blvd Ste 202, Los Angeles, CA 90025-6602 | 2019-11-21 |
| 1659930089 | Jade Kalelei Wilia | Pharmacy | 1411 N Mansfield Ave Apt 9, Los Angeles, CA 90028-7676 | 2019-06-10 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90046 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.