MIXLAB, INC. (NPI# 1649807140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649807140 |
| Entity Type | Organization |
| Organization Name | MIXLAB, INC. |
| Practice Address |
2223 Federal Ave Los Angeles CA 90064-1403 |
| Practice Telephone | 8889014480 |
| Practice Fax Number | 2129670892 |
| Mailing Telephone | 8889014480 |
| Mailing Fax Number | 2129670892 |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2020-03-25 |
| Authorized Official Name | VINH DAM (CHIEF PHARMACY OFFICER) |
| Authorized Official Telephone | 3476109820 |
| Authorized Official Credential | PHARMD, MS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407365679 | Mixlab, Inc. | Pharmacy | 336 W 37th St Rm 850, New York, NY 10018-4280 | 2017-09-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | MIXLAB, INC. | 336 W 37th St Rm 850, New York, NY 10018-4280 |
| Street Address |
2223 FEDERAL AVE |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90064-1403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134727597 | Barbara K. Polland | Marriage & Family Therapist | 10533 Rountree Rd., Los Angeles, CA 90064 | 2020-10-16 |
| 1912542994 | Reproductive Medicine Associates of Socal Ambulatory Surgery Center | Clinic/Center | 11500 W Olympic Blvd, Ste# 150, Los Angeles, CA 90064 | 2019-11-13 |
| 1376022012 | Payersdirect, Inc. | Radiology | 11845 W Olympic Blvd Ste 1100w, Los Angeles, CA 90064 | 2018-08-13 |
| 1013404136 | Jeannie Wakamatsu | Dietitian, Registered | 10312 Almayo Ave., Suite 6, Los Angeles, CA 90064 | 2018-04-13 |
| 1487153474 | Victor Louie | Behavior Technician | 11835 W Olympic Blvd Suite 140e, Los Angeles, CA 90064 | 2018-02-06 |
| 1538683842 | Ana Grinfeld | Behavioral Analyst | 11835 W Olympic Blvd Ste 140e, Los Angeles, CA 90064 | 2017-07-28 |
| 1407386089 | Ovsanna Stepanyan | Rehabilitation Practitioner | 11080 W Olimpic Blvd, La, CA 90064 | 2017-06-15 |
| 1952768012 | Grace Gayles | Behavioral Analyst | 11835 W. Olympic Blvd., Suite 140e, Los Angeles, CA 90064 | 2016-01-20 |
| 1669841003 | Jessica Hildebrandt | Occupational Therapy Assistant | 2446 S Westgate Ave, Los Angeles, CA 90064 | 2015-09-16 |
| 1033592571 | Joshua Busse | Family Medicine | 11845 Olympic Boulevard, Los Angeles, CA 90064 | 2015-07-01 |
| Find all providers in zip 90064 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| 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: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942820485 | Kaiser Foundation Health Plan Inc | Pharmacy | 5300 Mcconnell Ave Fl 1, Rm 1150, Los Angeles, CA 90066-7026 | 2020-04-24 |
| 1164042453 | Clover Care Pharmacy Inc | Pharmacy | 266 S Harvard Blvd Ste 140, Los Angeles, CA 90004-4389 | 2020-04-16 |
| 1831724244 | Pharmedquest Pharmacy Services | Pharmacy | 325 E. 7th Street, Room 101, Los Angeles, CA 90014-9001 | 2020-03-05 |
| 1568004083 | Ema Healthcare, Inc | Pharmacy | 447a E El Segundo Blvd, Los Angeles, CA 90061-2741 | 2019-10-16 |
| 1114568698 | Kaiser Foundation Health Plan Inc | Pharmacy | 7007 Romaine St, Los Angeles, CA 90038 | 2019-10-04 |
| 1538710025 | Pharmedquest Pharmacy Services | Pharmacy | 954 N Vermont Ave # 132, Los Angeles, CA 90029-3529 | 2019-09-25 |
| 1033604178 | Emily Wong | Pharmacy | 640 N Broadway Ste 3, Los Angeles, CA 90012-2815 | 2018-06-29 |
| 1447700737 | T & T Care, Inc | Pharmacy | 2015 Wilshire Blvd, Los Angeles, CA 90057-3503 | 2016-10-11 |
| 1851847982 | South Central Family Health Center | Pharmacy | 1109 E Vernon Ave, Los Angeles, CA 90011-3718 | 2016-08-29 |
| 1497109318 | Anita Ashoori | Pharmacy | 1520 Camden Ave, Los Angeles, CA 90025-3463 | 2016-04-17 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90064 |
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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.