Individual provider Active NPI

Lidija Ruskova, RPH

  • Pharmacist
  • Laguna Beach, CA
National Provider Identifier
1053802314
Registry record updated May 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
73682 Issued in CA
Practice address
244 Forest Ave
Laguna Beach, CA 92651-2114
Phone
(949) 494-1059
NPI assigned
May 22, 2018
Last updated
May 22, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 73682 CA Primary

Addresses

Primary practice location

244 Forest Ave
Laguna Beach, CA 92651-2114

Mailing address

3362 Watermarke PL
Irvine, CA 92612-5618
Phone (949) 378-6335

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
73682CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bushard Pharmacy Inc PastSince May 26, 2024 Accepting new patients
Bushard Pharmacy Inc Pharmacist Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1526947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526947200000",
    "number": "1053802314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3362 WATERMARKE PL",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926125618",
            "telephone_number": "949-378-6335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 FOREST AVE",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926512114",
            "telephone_number": "949-494-1059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSKOVA",
        "first_name": "LIDIJA",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-22",
        "last_updated": "2018-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "73682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2018; 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.