Gardena Center Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY41295 Issued in CA

Legal business name

GARDENA CENTER PHARMACY LLC

Practice address

15407 S Western Ave
Gardena, CA 90249-4318

Phone

(310) 767-1522

Fax

(310) 767-1174

NPI assigned

Jan 8, 2007

Organization subpart

No

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

Authorized official

Name

Bo Park

Title

Pharmacist and Owner

Phone

(310) 767-1522

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• GARDENA CENTER PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447027200000",
    "number": "1144378787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15407 S WESTERN AVE",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902494318",
            "telephone_number": "310-767-1522",
            "fax_number": "310-767-1174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15407 S WESTERN AVE",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902494318",
            "telephone_number": "310-767-1522",
            "fax_number": "310-767-1174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDENA CENTER PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2015-11-09",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "BO",
        "authorized_official_title_or_position": "PHARMACIST AND OWNER",
        "authorized_official_telephone_number": "310-767-1522"
    },
    "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": "PHY41295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA412950",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1996114",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GARDENA CENTER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sofia Alexandra Garcia, NONE
• Tatiana Garcia, NONE
• Wendy Lamarque Garcia
• Zayra Garcia
• Gardena Anesthesia Medical Services Inc
• Gardena Emergency Medical Associates Inc
• Gardena Flores Inc
• Gardena Hearing Inc
• Gardena Hospital LP
• Gardena Hospital LP

• All providers in Gardena, CA
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2015; 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.