Active NPI
Nima Rodefshalom, PHARM.D
- Pharmacist
- Los Angeles, CA
National Provider Identifier
1275677510
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Oct 29, 2021.
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 55990
- Practice address
- 1529 Rexford Dr
Los Angeles, CA 90035-3109 - Phone
- (310) 670-3829
- NPI assigned
- Feb 19, 2007
- 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 | 55990 | CA | Primary |
Addresses
Primary practice location
1529 Rexford Dr
Los Angeles, CA 90035-3109
Mailing address
1529 Rexford Dr
Los Angeles, CA 90035-3109
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 55990 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351814400000",
"number": "1275677510",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1529 REXFORD DR",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900353109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1529 REXFORD DR",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900353109",
"telephone_number": "310-670-3829"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODEFSHALOM",
"first_name": "NIMA",
"credential": "PHARM.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-19",
"last_updated": "2012-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "55990",
"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 Nov 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.