Active NPI
Yevgeniya Avagimova
- Pharmacist
- Los Angeles, CA
National Provider Identifier
1194597716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 78585
- Practice address
- 808 W 58TH St
Los Angeles, CA 90037-3632 - Phone
- (323) 541-1600
- NPI assigned
- Oct 26, 2023
- Sex
- Female
- 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 | 78585 | CA | Primary |
Addresses
Primary practice location
808 W 58TH St
Los Angeles, CA 90037-3632
Mailing address
350 The VLG
Redondo Beach, CA 90277-2650
Phone (909) 557-4252
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
| License | State | Type | Specialty |
|---|---|---|---|
| 78585 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698278400000",
"number": "1194597716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "350 THE VLG",
"city": "REDONDO BEACH",
"state": "CA",
"postal_code": "902772650",
"telephone_number": "909-557-4252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "808 W 58TH ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900373632",
"telephone_number": "323-541-1600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVAGIMOVA",
"first_name": "YEVGENIYA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-10-26",
"last_updated": "2023-10-26",
"certification_date": "2023-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "78585",
"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 Oct 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.