Ciroca Corp.

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

License

PHY46241 Issued in CA

Legal business name

CIROCA CORP.

Practice address

13624 Hawthorne Blvd
Suite 102
Hawthorne, CA 90250-5818

Phone

(310) 679-9844

Fax

(310) 679-7964

NPI assigned

Aug 2, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Jairo De la Rosa

Title

Vicepresident

Phone

(310) 679-9844

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Supermarket Pharmacy and Health Care Center Doing business as

Locations

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1366443103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13624 HAWTHORNE BLVD",
            "address_2": "SUITE 102",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902505818",
            "telephone_number": "310-679-9844",
            "fax_number": "310-679-7964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13624 HAWTHORNE BLVD",
            "address_2": "SUITE 102",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902505818",
            "telephone_number": "310-679-9844",
            "fax_number": "310-679-7964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CIROCA CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-02",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "DE LA ROSA",
        "authorized_official_first_name": "JAIRO",
        "authorized_official_title_or_position": "VICEPRESIDENT",
        "authorized_official_telephone_number": "310-679-9844",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "PHY46241",
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "CA",
            "license": "PHY46241",
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "CA",
            "license": "PHY46241",
            "primary": true
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "PHY46241",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "0578875",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA462410",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Supermarket Pharmacy and Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tina Timmy Chung, LCSW
• Joy Chunratanachai, LVN
• Donna Cicchesi, DPT
• Jacqueline Ann Ciccone, RN, BSN, MSN, CLC
• Angie Michelle Cifuentes
• Citycare Homehealth Provider Inc
• Kimberly Michonne Clark-Holloway
• Brandt Clark, PT
• Kayla Clark
• Christal Clarke

• Oxygen Equipment & Supplies (DME) in Hawthorne, CA
• Providers in Hawthorne, CA by specialty
• Oxygen Equipment & Supplies (DME) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.