Active NPI
Edward William Ildefonso Pamanian, PHARM.D
- Pharmacist
- Bakersfield, CA
National Provider Identifier
1245072685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 89443
- Practice address
- 11300 Ming Ave
Bakersfield, CA 93311-1300 - Phone
- (661) 664-0187
- NPI assigned
- Jun 7, 2024
- Last updated
- Jun 7, 2024
- Sex
- Male
- Sole proprietor
- No
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 | 89443 | CA | Primary |
Addresses
Primary practice location
11300 Ming Ave
Bakersfield, CA 93311-1300
Mailing address
21910 Roscoe Blvd Apt 210
Canoga Park, CA 91304-3965
Phone (818) 271-7290
Other names 1
- Edward Ildefonso Pamanian
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 89443 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Garfield Beach CVS LLC | Past | Accepting new patients | |
| Garfield Beach CVS, L.L.C. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717718400000",
"number": "1245072685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21910 ROSCOE BLVD APT 210",
"city": "CANOGA PARK",
"state": "CA",
"postal_code": "913043965",
"telephone_number": "818-271-7290"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11300 MING AVE",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933111300",
"telephone_number": "661-664-0187"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAMANIAN",
"first_name": "EDWARD WILLIAM",
"middle_name": "ILDEFONSO",
"credential": "PHARM.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-06-07",
"last_updated": "2024-06-07",
"certification_date": "2024-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "89443",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "EDWARD",
"last_name": "PAMANIAN",
"middle_name": "ILDEFONSO",
"credential": "PHARM.D",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Bakersfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.