Individual provider Active NPI

Adil Amirali Colabawala

  • Pharmacist
  • Los Angeles, CA
National Provider Identifier
1134880941
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
85650 Issued in CA
Practice address
4030 S Western Ave
Los Angeles, CA 90062-1634
Phone
(323) 292-7009
NPI assigned
Jan 4, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 85650 CA Primary

Addresses

Primary practice location

4030 S Western Ave
Los Angeles, CA 90062-1634

Mailing address

8821 Lindley Ave
Northridge, CA 91325-3024
Phone (818) 573-7747

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

State licenses

LicenseStateTypeSpecialty
85650CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Garfield Beach CVS LLC PastSince Jan 17, 2022 Accepting new patients
Garfield Beach CVS, L.L.C. PastSince Jan 17, 2022 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1641254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1134880941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8821 LINDLEY AVE",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913253024",
            "telephone_number": "818-573-7747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4030 S WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900621634",
            "telephone_number": "323-292-7009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLABAWALA",
        "first_name": "ADIL",
        "middle_name": "AMIRALI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-04",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "85650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jan 5, 2022; 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.