Heritage Compounding Pharmacy

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

PHY47098 Issued in CA

Legal business name

HERITAGE COMPOUNDING PHARMACY

Practice address

2903 Saturn St Ste a
Brea, CA 92821-6259

Phone

(714) 579-1636

NPI assigned

Feb 2, 2007

Organization subpart

No

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

Authorized official

Name

Esther Kim

Title

Pharm. D.

Phone

(714) 579-1636

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104964840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2903 SATURN ST STE A",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928216259"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE COMPOUNDING PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "ESTHER",
        "authorized_official_title_or_position": "PHARM. D.",
        "authorized_official_telephone_number": "714-579-1636"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "CA",
            "license": "PHY47098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 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
• Shonna Marie Hill, PSYD.

• Compounding Pharmacy in Brea, CA
• Providers in Brea, CA by specialty
• Compounding Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.