Heritage Compounding Pharmacy

Primary specialty

PharmacistTaxonomy code 183500000X

License

22225 Issued in CA

Legal business name

HERITAGE COMPOUNDING PHARMACY

Practice address

2903 Saturn St Ste a
Brea, CA 92821-6259

Phone

(714) 579-1636

Fax

(714) 579-1682

NPI assigned

Sep 3, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Sylvia A Moore, PHARM.D.NPI 1912378654

Title

Pharmacist in Charge

Phone

(714) 579-1636

Specialties & licenses 1

Addresses

Tax ID family

Heritage Compounding Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Precision Pharmacy Center, LLC

  • Pharmacy
  • Brea, CA
  • NPI 1497147425
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sylvia Ann Moore, PHARM.D

  • Pharmacist
  • Brea, CA
  • NPI 1912378654
  NPD (past) Authorized official

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

{
    "created_epoch": "1441238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441238400000",
    "number": "1093183303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30802 COAST HWY",
            "address_2": "SPC. D8",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926514207",
            "telephone_number": "949-235-0343",
            "fax_number": "714-579-1682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2903 SATURN ST STE A",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928216259",
            "telephone_number": "714-579-1636",
            "fax_number": "714-579-1682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE COMPOUNDING PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-03",
        "last_updated": "2015-09-03",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "SYLVIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "714-579-1636",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "22225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Afsaneh Golshan Helali, NP
• Paul M. Heller, D.C.
• Mary Henein, PSY D
• Earl R Henslin, PSY.D.
• Herbert J. Simons, MD
• Heritage Compounding Pharmacy
• Angelica Hernandez, MS
• Cezar Hernandez
• Gabriela Angelica Hernandez
• Donna Lorraine Hicks, MA, LMFT

• Pharmacist in Brea, CA
• Providers in Brea, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2015; 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.