Active NPI
Sura E Stephan, RPH
- Pharmacist
- North Hollywood, CA
National Provider Identifier
1134725567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 78609
- Practice address
- 10945 Victory Blvd
North Hollywood, CA 91606-3717 - Phone
- (818) 487-0119
- NPI assigned
- Dec 10, 2020
- Last updated
- Dec 15, 2020
- Sex
- Female
- 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 | 78609 | CA | Primary |
Addresses
Primary practice location
10945 Victory Blvd
North Hollywood, CA 91606-3717
Mailing address
10945 Victory Blvd
North Hollywood, CA 91606-3717
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | surastephan@yahoo.com |
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
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": "1607558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607990400000",
"number": "1134725567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10945 VICTORY BLVD",
"city": "NORTH HOLLYWOOD",
"state": "CA",
"postal_code": "916063717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10945 VICTORY BLVD",
"city": "NORTH HOLLYWOOD",
"state": "CA",
"postal_code": "916063717",
"telephone_number": "818-487-0119"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEPHAN",
"first_name": "SURA",
"middle_name": "E",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-12-10",
"last_updated": "2020-12-15",
"certification_date": "2020-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "78609",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "surastephan@yahoo.com",
"affiliation": "N",
"address_1": "424 Oak St Unit 333",
"city": "Glendale",
"state": "CA",
"country_code": "US",
"postal_code": "912041289",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in North Hollywood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.