Active NPI
Melissa Evanich
- Pharmacist
- Los Angeles, CA
National Provider Identifier
1023317203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH66919
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| RPH66919 | CA | MD | Pharmacist |
| RP046252 | PA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| United Medcare | Current | Accepting new patients | |
| Thrift Drug Inc | Past | Accepting new patients | |
| United Medcare | Past | 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.
-
- Community/Retail Pharmacy
- Los Angeles, CA
- NPI 1245397512
-
- Long Term Care Pharmacy
- Los Angeles, CA
- NPI 1184127805
-
- Community/Retail Pharmacy
- Hamburg, NJ
- NPI 1114026341
-
- Community/Retail Pharmacy
- Wilkes Barre, PA
- NPI 1659470904
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.