Active NPI
David Mirakhor, PHARMD
- Pharmacist
- Los Angeles, CA
National Provider Identifier
1366912834
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 79979
- Practice address
- 303 S la Brea Ave
Los Angeles, CA 90036-3526 - Phone
- (323) 634-0743
- NPI assigned
- Nov 28, 2018
- 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 | 79979 | CA | Primary |
Addresses
Primary practice location
303 S la Brea Ave
Los Angeles, CA 90036-3526
Mailing address
9045 Wilshire Blvd
Beverly Hills, CA 90211-1829
Phone (310) 273-5252
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 |
|---|---|---|---|
| 79979 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Garfield Beach CVS, L.L.C. | Past | Accepting new patients | |
| Garfield Beach CVS LLC | Past | Accepting new patients | |
| Garfield Beach CVS LLC | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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- Pharmacy
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- NPI 1558619395
-
- Pharmacy
- Jurupa Valley, CA
- NPI 1780573113
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710374400000",
"number": "1366912834",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9045 WILSHIRE BLVD",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "902111829",
"telephone_number": "310-273-5252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "303 S LA BREA AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900363526",
"telephone_number": "323-634-0743"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIRAKHOR",
"first_name": "DAVID",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-11-28",
"last_updated": "2024-03-14",
"certification_date": "2024-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "CA",
"license": "79979",
"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 Mar 14, 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.