CDM Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

CDM PHARMACY

Doing business as

Balboa Pharmacy

Practice address

716 E Balboa Blvd
Newport Beach, CA 92661-1306

Phone

(949) 673-5370

Fax

(949) 673-3600

NPI assigned

Jan 12, 2007

Last updated

Mar 31, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jeffrey Brian Ford

Title

Ceo

Phone

(949) 673-5370

Specialties & licenses 1

Addresses

Other names 1

• Balboa Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Thomas Alan Boragno, PHARM D

  • Pharmacist
  • Newport Beach, CA
  • NPI 1225667132
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585612800000",
    "number": "1255482709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 E BALBOA BLVD",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926611306",
            "telephone_number": "949-673-5370",
            "fax_number": "949-673-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 E BALBOA BLVD",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926611306",
            "telephone_number": "949-673-5370",
            "fax_number": "949-673-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CDM PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "BRIAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-673-5370",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Balboa Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Diana L Catsoulas, ALTERNATIVE MEDICINE
• Brian D. Cauley, MD
• Robert John Cavalieri, DDS
• Cavender Medical Corporation
• CCRM Newport Beach
• Joshua Samuel Ceballos, LMT
• Angelica Delval Cecena
• Susan J Cederstrom, M.D.
• Cedric Choan MD Inc
• Alexandria Cefalu

• Community/Retail Pharmacy in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.