Bravo Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY49276 Issued in CA

Legal business name

BRAVO PHARMACY LLC

Doing business as

Bravo Pharmacy

Practice address

10211 Avalon Blvd
Los Angeles, CA 90003-4819

Phone

(323) 757-2727

Fax

(323) 575-2722

NPI assigned

Sep 30, 2008

Organization subpart

No

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

Authorized official

Name

Sang Kim

Title

Ceo

Phone

(310) 618-1988

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bravo Pharmacy Doing business as

Locations

Practitioners 1

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

• Fred Kiho Cho, PHARM.D.

  • Pharmacist
  • Anaheim, CA
  • NPI 1205015625
  NPD

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

{
    "created_epoch": "1222732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321315200000",
    "number": "1104076884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2275 TORRANCE BLVD",
            "address_2": "SUITE101",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905012550",
            "telephone_number": "310-618-1988",
            "fax_number": "310-618-1996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10211 AVALON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900034819",
            "telephone_number": "323-757-2727",
            "fax_number": "323-575-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAVO PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-30",
        "last_updated": "2011-11-15",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "SANG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-618-1988"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY49276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5632422",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bravo Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Debra L. Brause, PSY.D.
• Monica Brautovich, MSW
• Brava Rehab Services, Inc
• Monica Bravo Esouivel
• Lizzy Bravo Nunez
• Bravo Pharmacy LLC
• Kelly Bravo-Cuevas
• Rocio Bravo-Garcia
• Crystal Bravo-Rodriguez
• Amanda Joy Bravo

• Community/Retail Pharmacy in Los Angeles, CA
• Providers in Los Angeles, 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 Nov 15, 2011; 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.