Casa Blanca Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

54575 Issued in CA

Legal business name

CASA BLANCA PHARMACY INC

Doing business as

Casa Blanca Pharmacy

Practice address

2012 Glenoaks Blvd
San Fernando, CA 91340-1625

Phone

(818) 698-4390

Fax

(818) 698-4387

NPI assigned

Aug 26, 2015

Last updated

Oct 31, 2016By 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

George Gevorkyan

Title

Ceo/Owner

Phone

(818) 698-4390

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Casa Blanca Pharmacy Doing business as

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

{
    "created_epoch": "1440547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477872000000",
    "number": "1033586953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2012 GLENOAKS BLVD",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913401625",
            "telephone_number": "818-698-4390",
            "fax_number": "818-698-4387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2012 GLENOAKS BLVD",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913401625",
            "telephone_number": "818-698-4390",
            "fax_number": "818-698-4387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASA BLANCA PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-26",
        "last_updated": "2016-10-31",
        "status": "A",
        "authorized_official_last_name": "GEVORKYAN",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "818-698-4390"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "54575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2153949",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Casa Blanca Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kriss Marie Carlson
• Evelyn Escalona Carranza, LCSW
• Jamie Carranza
• Melissa Carreon, RBT
• Maricela Carrillo
• Dezerae Casares, BCBA
• Marlen Casillas
• Andres Felipe Castaneda
• Angie Castell
• Veronica Castellanos, NURSE PRACTITIONER

• Community/Retail Pharmacy in San Fernando, CA
• Providers in San Fernando, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2016; 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.