Active NPI
Albert Joseph Pellicano, BS OF PHARMACY
- Pharmacist
- Los Angeles, CA
National Provider Identifier
1174917801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- A29903
- Practice address
- 10861 Weyburn Ave
Los Angeles, CA 90024-2957 - Phone
- (310) 824-5013
- Fax
- (310) 824-5719
- NPI assigned
- Mar 19, 2015
- Sex
- Male
- 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 | A29903 | CA | Primary |
Addresses
Primary practice location
10861 Weyburn Ave
Los Angeles, CA 90024-2957
Mailing address
10861 Weyburn Ave
Los Angeles, CA 90024-2957
Phone (310) 824-5013
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
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A29903 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1426723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426723200000",
"number": "1174917801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10861 WEYBURN AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900242957",
"telephone_number": "310-824-5013",
"fax_number": "310-824-5719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10861 WEYBURN AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900242957",
"telephone_number": "310-824-5013",
"fax_number": "310-824-5719"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PELLICANO",
"first_name": "ALBERT",
"middle_name": "JOSEPH",
"name_prefix": "Mr.",
"credential": "BS OF PHARMACY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-03-19",
"last_updated": "2015-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "A29903",
"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 Mar 19, 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.