NPIMap

Individual provider Active NPI

Mireille Ishac

  • Pharmacist
  • Tujunga, CA
National Provider Identifier
1184153207
Registry record updated Jun 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
60635 Issued in CA
Practice address
6588 Foothill Blvd
Tujunga, CA 91042-2705
Phone
(818) 446-0647
NPI assigned
Jun 12, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 60635 CA Primary

Addresses

Primary practice location

6588 Foothill Blvd
Tujunga, CA 91042-2705

Mailing address

3943 San Fernando Rd
Glendale, CA 91204-2721

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
60635CAMDRecreation Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Garfield Beach CVS LLC Past Accepting new patients
Garfield Beach CVS, L.L.C. Past Accepting new patients
Garfield Beach CVS, L.L.C. Past Accepting new patients

Organizations & group practices 3

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": "1497225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497225600000",
    "number": "1184153207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3943 SAN FERNANDO RD",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6588 FOOTHILL BLVD",
            "city": "TUJUNGA",
            "state": "CA",
            "postal_code": "910422705",
            "telephone_number": "818-446-0647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISHAC",
        "first_name": "MIREILLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-12",
        "last_updated": "2017-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "60635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tujunga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2017; 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.