California Specialty Pharmacy LLC

Primary specialty

Home Infusion Therapy PharmacyTaxonomy code 3336H0001X

Legal business name

CALIFORNIA SPECIALTY PHARMACY LLC

Practice address

12110 Hadley St Ste B
Whittier, CA 90601-3912

Phone

(877) 802-7779

Fax

(866) 853-6555

NPI assigned

Jul 2, 2010

Organization subpart

No

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

Authorized official

Name

Dr. George Worthington Kridner IV, PHARMDNPI 1578537700

Title

President/Ceo

Phone

(714) 981-6871

Specialties & licenses 6

Addresses

Other identifiers 5

Other names 1

• California Specialty Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 6

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

• George Worthington Kridner, PHARMD

  • Pharmacist
  • Whittier, CA
  • NPI 1578537700
  NPD Authorized official
• Bhavesh Desai, PHARM.D.

  • Pharmacist
  • Yucaipa, CA
  • NPI 1295955136
  NPD
• Sumit Desai, PHARM.D.

  • Pharmacist
  • San Bernardino, CA
  • NPI 1760602692
  NPD
• Andrew Pham, PHARMD

  • Pharmacist
  • Whittier, CA
  • NPI 1336061704
  NPD (past)
• Kevin Vannukul, RPH

  • Pharmacist
  • Whittier, CA
  • NPI 1790250793
  NPD (past)
• Sierra Nicole Brandt-Gray, PHARMD

  • Pharmacist
  • Portland, OR
  • NPI 1710857743
  NPD (past)

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

{
    "created_epoch": "1278028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767052800000",
    "number": "1114239332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12110 HADLEY ST STE B",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906013912",
            "telephone_number": "877-802-7779",
            "fax_number": "866-853-6555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12110 HADLEY ST STE B",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906013912",
            "telephone_number": "877-802-7779",
            "fax_number": "866-853-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA SPECIALTY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-02",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A",
        "authorized_official_last_name": "KRIDNER",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "WORTHINGTON",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "714-981-6871",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "IV",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "HI",
            "license": "PMP-666",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "FL",
            "license": "PH24882",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "54320",
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114239332",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "7485260001",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101349024",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF CALIFORNIA DEPARTMENT OF PUBLIC HEALTH - HOME HEALTH",
            "identifier": "550007732",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2125569",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "California Specialty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "California Specialty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Octavio Calderon Jr.
• Sylvia Gail Caldwell, DC
• Cali Assisted Transportation
• California Addiction Medical Group, Inc.
• California Geriatric Psychological Services Inc
• Tasmin N. Caliste Tancora, PA-C
• Aseneth Calvillo Martinez
• Alyssa Camacho, SLPA
• Joanna Camacho
• Anna Liza Dela Pena Camandang, SLPA

• All providers in Whittier, CA
• Home Infusion Therapy Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.