Active NPI
Edmond Reyhani
- Pharmacist
- Winnetka, CA
National Provider Identifier
1104290485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 64743
- Practice address
- 20839 W Roscoe Blvd
Winnetka, CA 91306 - Phone
- (818) 701-8911
- Fax
- (818) 701-8916
- NPI assigned
- Nov 24, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 64743 | CA | Primary |
Addresses
Primary practice location
20839 W Roscoe Blvd
Winnetka, CA 91306
Mailing address
20839 W Roscoe Blvd
Winnetka, CA 91306
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 64743 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Garfield Beach CVS, L.L.C. | Past | Accepting new patients | |
| Garfield Beach CVS LLC | 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 and National Provider Directory roles.
-
- Pharmacy
- Winnetka, CA
- NPI 1669416939
-
- Pharmacy
- Jurupa Valley, CA
- NPI 1780573113
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1448323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1448323200000",
"number": "1104290485",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20839 W ROSCOE BLVD",
"city": "WINNETKA",
"state": "CA",
"postal_code": "91306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20839 W ROSCOE BLVD",
"city": "WINNETKA",
"state": "CA",
"postal_code": "91306",
"telephone_number": "818-701-8911",
"fax_number": "818-701-8916"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYHANI",
"first_name": "EDMOND",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-11-24",
"last_updated": "2015-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "64743",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winnetka, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 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.