Custom RX Pharmacy

Primary specialty

PharmacistTaxonomy code 183500000X

License

46817710 Issued in CA

Legal business name

CUSTOM RX PHARMACY

Practice address

731 1/2 N la Brea Ave
Los Angeles, CA 90038-3338

Phone

(323) 937-7879

NPI assigned

Oct 20, 2006

Last updated

Aug 24, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael Imanoel

Title

Pharmacist (President)

Phone

(323) 937-7879

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251072000000",
    "number": "1023190774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 48408",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900480408",
            "telephone_number": "323-937-7879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 1/2 N LA BREA AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900383338",
            "telephone_number": "323-937-7879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM RX PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2009-08-24",
        "status": "A",
        "authorized_official_last_name": "IMANOEL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PHARMACIST (PRESIDENT)",
        "authorized_official_telephone_number": "323-937-7879"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "46817710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Cushing, MD
• Lucas Allen Cushman
• Adam Custer, MD
• Leilani Custodio
• Ma. Franchette Berna Custodio
• Lucas Russell Cusumano
• Chelsea Abigail Dionisio Cutaran, CRNA
• Brianna Cuthbertson, RRT, RCP
• Laura Denise Cutler, MA, LMFT
• Nicholas J Cutri, D.P.T.

• Pharmacist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.