Organization Active NPI

Tratt

Doing business as Lotus Pharmacy

  • Community/Retail Pharmacy
  • San Gabriel, CA
National Provider Identifier
1104169531
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
TRATT
Doing business as
Lotus Pharmacy
Practice address
1135 S San Gabriel Blvd
#2
San Gabriel, CA 91776-3114
Phone
(626) 872-0181
Fax
(626) 872-0182
NPI assigned
Apr 4, 2013
Last updated
Feb 1, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

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

Authorized official

Name
Yu-Ling Benjamin LiaoNPI 1336701150
Title
Owner/Pic
Phone
(626) 872-0181

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

1135 S San Gabriel Blvd
#2
San Gabriel, CA 91776-3114

Mailing address

1135 S San Gabriel Blvd
#2
San Gabriel, CA 91776-3114
Phone (626) 872-0181

Other identifiers 1

IdentifierTypeStateIssuer
1104169531MedicaidCA

Other names 1

  • LOTUS PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210111001201 CA Part B Supplier - Pharmacy 8022421130 Practice locations: San Gabriel, CA

National Provider Directory

National Provider Directory

Locations

1135 S San Gabriel Blvd
#2
San Gabriel, CA 91776
Phone (626) 872-0181

1135 S San Gabriel Blvd
Ste 2
San Gabriel, CA 91776
Phone (626) 872-0181

1135 S San Gabriel Blvd
Unit 2
San Gabriel, CA 91776
Phone (626) 872-0181

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1365033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643673600000",
    "number": "1104169531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 S SAN GABRIEL BLVD",
            "address_2": "#2",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917763114",
            "telephone_number": "626-872-0181",
            "fax_number": "626-872-0182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 S SAN GABRIEL BLVD",
            "address_2": "#2",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917763114",
            "telephone_number": "626-872-0181",
            "fax_number": "626-872-0182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRATT",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-04",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A",
        "authorized_official_last_name": "LIAO",
        "authorized_official_first_name": "YU-LING",
        "authorized_official_middle_name": "BENJAMIN",
        "authorized_official_title_or_position": "OWNER/PIC",
        "authorized_official_telephone_number": "626-872-0181"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104169531",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LOTUS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LOTUS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Gabriel, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.