Active NPI
Maxwell Addo, RPH
- Pharmacist
- Los Angeles, CA
National Provider Identifier
1104397611
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 79367
- Practice address
- 1025 E Adams Blvd
Los Angeles, CA 90011-5522 - Phone
- (213) 742-6849
- NPI assigned
- Dec 9, 2018
- Last updated
- Dec 9, 2018
- 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 | 79367 | CA | Primary |
Addresses
Primary practice location
1025 E Adams Blvd
Los Angeles, CA 90011-5522
Mailing address
1025 E Adams Blvd
Los Angeles, CA 90011-5522
Phone (213) 742-6849
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
| License | State | Type | Specialty |
|---|---|---|---|
| 79367 | 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, 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": "1544313600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1544313600000",
"number": "1104397611",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1025 E ADAMS BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900115522",
"telephone_number": "213-742-6849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1025 E ADAMS BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900115522",
"telephone_number": "213-742-6849"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADDO",
"first_name": "MAXWELL",
"name_prefix": "Dr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-12-09",
"last_updated": "2018-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "79367",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
- Addiction Research and Treatment, Inc (MedMark Treatment Centers Los Angeles)
- Addiction Research and Treatment, Inc.
- Addiction Research and Treatment, Inc. (BAART Programs Boyle Heights)
- Addiction Research and Treatment, Inc. (BAART Programs Beverly)
- Princess Addison
- Luana Adduci, MA, AMFT
- Addus Healthcare, Inc. (Addus HomeCare)
- Drew Kevin Addy, DDS
- Taiye Adeagbo
- Oludara Adeeyo
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.