Knolls Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY36924 Issued in CA

Legal business name

KNOLLS PHARMACY

Practice address

16630 Marquez Ave
Pacific Palisades, CA 90272-3233

Phone

(310) 454-6000

Fax

(310) 454-0605

NPI assigned

Mar 5, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Gordon Wong, PHARMDNPI 1710987433

Title

Owner Pharmacist

Phone

(310) 454-6000

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Gordon Wong Other name

Locations

Practitioners 1

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

• Gordon Wong

  • Pharmacist
  • Pacific Palisades, CA
  • NPI 1710987433
  NPD (past) Authorized official

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510876800000",
    "number": "1124157904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16630 MARQUEZ AVE",
            "city": "PACIFIC PALISADES",
            "state": "CA",
            "postal_code": "902723233",
            "telephone_number": "310-454-6000",
            "fax_number": "310-454-0605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16630 MARQUEZ AVE",
            "city": "PACIFIC PALISADES",
            "state": "CA",
            "postal_code": "902723233",
            "telephone_number": "310-454-6000",
            "fax_number": "310-454-0605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KNOLLS PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2017-11-17",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "GORDON",
        "authorized_official_title_or_position": "OWNER PHARMACIST",
        "authorized_official_telephone_number": "310-454-6000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY36924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1994466",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gordon Wong",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Luke Kim, DENTIST
• Mary-Margaret Shaffer Kim, M.D.
• Laura Kirkland
• Francine Kirkpatrick, PH.D.
• Elizabeth Ann Knickmeyer
• Daniel Knox, CADC I, MBA
• Stephen A Koff, DC
• Ben Kohn, M.D.
• Edward Christopher Kolpin, D.O.
• Viktoriya Kostikian

• Community/Retail Pharmacy in Pacific Palisades, CA
• Providers in Pacific Palisades, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2017; 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.