Clinical Compounding Pharmacy

Primary specialty

PharmacyTaxonomy code 333600000X

License

50743 Issued in CA

Legal business name

CLINICAL COMPOUNDING PHARMACY

Doing business as

Great Earth Compounds

Practice address

8941 Santa Monica Blvd
West Hollywood, CA 90069-4912

Phone

(323) 650-0025

Fax

(323) 650-0029

NPI assigned

Jan 22, 2008

Last updated

Dec 1, 2011By 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

Helen Kizler

Title

President/Pic

Phone

(323) 650-0025

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Great Earth Compounds Doing business as

Locations

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

{
    "created_epoch": "1200960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322697600000",
    "number": "1316123334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8941 SANTA MONICA BLVD",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900694912",
            "telephone_number": "323-650-0025",
            "fax_number": "323-650-0029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8941 SANTA MONICA BLVD",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900694912",
            "telephone_number": "323-650-0025",
            "fax_number": "323-650-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL COMPOUNDING PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-22",
        "last_updated": "2011-12-01",
        "status": "A",
        "authorized_official_last_name": "KIZLER",
        "authorized_official_first_name": "HELEN",
        "authorized_official_title_or_position": "PRESIDENT/PIC",
        "authorized_official_telephone_number": "323-650-0025"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "50743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5629110",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great Earth Compounds",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• David Earl Cohen, MD PHD
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• Pharmacy in West Hollywood, CA
• Providers in West Hollywood, CA by specialty
• Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2011; 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.