Individual provider Active NPI

Melissa Evanich

  • Pharmacist
  • Los Angeles, CA
National Provider Identifier
1023317203
Registry record updated Mar 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH66919 Issued in CA
Practice address
1127 Wilshire Blvd Ste 201
Los Angeles, CA 90017-3903
Phone
(213) 482-0644
NPI assigned
Mar 27, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP046252 PA
Pharmacist 183500000X RPH66919 CA Primary

Addresses

Primary practice location

1127 Wilshire Blvd Ste 201
Los Angeles, CA 90017-3903

Mailing address

1127 Wilshire Blvd Ste 201
Los Angeles, CA 90017-3903
Phone (213) 482-0644

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

State licenses

LicenseStateTypeSpecialty
RPH66919CAMDPharmacist
RP046252PAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
United Medcare CurrentSince May 16, 2021 Accepting new patients
Thrift Drug Inc Past Accepting new patients
United Medcare PastSince Mar 22, 2020 Accepting new patients
Thrift Drug Inc Past Accepting new patients

Locations

1127 Wilshire Blvd
Ste 201
Los Angeles, CA 90017
Phone (213) 482-0644

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1301184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584662400000",
    "number": "1023317203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1127 WILSHIRE BLVD STE 201",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900173903",
            "telephone_number": "213-482-0644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 WILSHIRE BLVD STE 201",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900173903",
            "telephone_number": "213-482-0644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANICH",
        "first_name": "MELISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-27",
        "last_updated": "2020-03-20",
        "certification_date": "2020-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP046252",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH66919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2020; 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.