NPIMap

Organization Active NPI

Watts Clinic Pharmacy

  • Clinic Pharmacy
  • Los Angeles, CA
National Provider Identifier
1124165956
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
PHY46869 Issued in CA
Legal business name
WATTS CLINIC PHARMACY
Practice address
10300 Compton Ave
Los Angeles, CA 90002-3628
Phone
(714) 926-7131
NPI assigned
Jan 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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

Authorized official

Name
Ms. Dalila Ibarra
Title
Licensing & Credentialing Coordinat
Phone
(714) 599-8181

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X PHY46869 CA Primary

Addresses

Primary practice location

10300 Compton Ave
Los Angeles, CA 90002-3628

Mailing address

10604 Coursey Blvd
Baton Rouge, LA 70816-4015
Phone (714) 599-8181

Other identifiers 3

IdentifierTypeStateIssuer
5615591OtherCANCPDP NUMBER
PHY46869OtherCASTATE LICENSE
PHA463330MedicaidCA

Other names 1

  • Pharmedquest Pharmacy Services Other name

National Provider Directory

National Provider Directory
Tax ID family
Pharmedquest Pharmacy14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677456000000",
    "number": "1124165956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10604 COURSEY BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708164015",
            "telephone_number": "714-599-8181",
            "fax_number": "714-599-8242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 COMPTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900023628",
            "telephone_number": "714-926-7131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATTS CLINIC PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-09",
        "status": "A",
        "authorized_official_last_name": "IBARRA",
        "authorized_official_first_name": "DALILA",
        "authorized_official_title_or_position": "LICENSING & CREDENTIALING COORDINAT",
        "authorized_official_telephone_number": "714-599-8181",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "CA",
            "license": "PHY46869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP NUMBER",
            "identifier": "5615591",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PHY46869",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA463330",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pharmedquest Pharmacy Services",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Pharmedquest Pharmacy Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; 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.