Individual provider Active NPI

Priscilla Eusebio, PRH

  • Pharmacist
  • Los Angeles, CA
National Provider Identifier
1154720480
Registry record updated Aug 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
36023 Issued in CA
Practice address
2922 Division St
Los Angeles, CA 90065-1233
Phone
(323) 222-7982
Fax
(323) 222-3207
NPI assigned
Aug 22, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 36023 CA Primary

Addresses

Primary practice location

2922 Division St
Los Angeles, CA 90065-1233

Mailing address

2922 Division St
Los Angeles, CA 90065-1233
Phone (323) 222-7982

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
36023CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Varda Samboul Past Accepting new patients

Organizations & group practices 1

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": "1408665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408665600000",
    "number": "1154720480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2922 DIVISION ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900651233",
            "telephone_number": "323-222-7982",
            "fax_number": "323-222-3207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2922 DIVISION ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900651233",
            "telephone_number": "323-222-7982",
            "fax_number": "323-222-3207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EUSEBIO",
        "first_name": "PRISCILLA",
        "credential": "PRH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-22",
        "last_updated": "2014-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "36023",
            "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 Aug 22, 2014; 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.