Individual provider Active NPI

Gillian Christian Benavides, RPH

  • Pharmacist
  • Palmdale, CA
National Provider Identifier
1396455648
Registry record updated Apr 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
87334 Issued in CA
Practice address
37160 47TH St E
Palmdale, CA 93552-4450
Phone
(661) 236-0015
NPI assigned
Nov 28, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 87334 CA Primary

Addresses

Primary practice location

37160 47TH St E
Palmdale, CA 93552-4450

Mailing address

37160 47TH St E
Palmdale, CA 93552-4450

Other practice location 1

3756 Santa Rosalia Dr
Los Angeles, CA 90008-3606
Phone (323) 295-5585

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
87334CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co PastSince Apr 9, 2023 Accepting new patients
Walgreen Co PastSince Apr 9, 2023 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1669593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680825600000",
    "number": "1396455648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37160 47TH ST E",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935524450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37160 47TH ST E",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935524450",
            "telephone_number": "661-236-0015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3756 Santa Rosalia Dr",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900083606",
            "country_code": "US",
            "telephone_number": "323-295-5585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENAVIDES",
        "first_name": "GILLIAN",
        "middle_name": "CHRISTIAN",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-28",
        "last_updated": "2023-04-07",
        "certification_date": "2023-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "87334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2023; 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.