Active NPI
Jill Gungap
- Pharmacist
- Marina del Rey, CA
National Provider Identifier
1407132541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH 53062
- Practice address
- 4009 Lincoln Blvd
Marina del Rey, CA 90292-5613 - Phone
- (310) 823-7152
- NPI assigned
- Nov 2, 2011
- Last updated
- Nov 2, 2011
- Sex
- Female
- Sole proprietor
- No
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 | RPH 53062 | CA | Primary |
Addresses
Primary practice location
4009 Lincoln Blvd
Marina del Rey, CA 90292-5613
Mailing address
4009 Lincoln Blvd
Marina del Rey, CA 90292-5613
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH 53062 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320192000000",
"number": "1407132541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4009 LINCOLN BLVD",
"city": "MARINA DEL REY",
"state": "CA",
"postal_code": "902925613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4009 LINCOLN BLVD",
"city": "MARINA DEL REY",
"state": "CA",
"postal_code": "902925613",
"telephone_number": "310-823-7152"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUNGAP",
"first_name": "JILL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-02",
"last_updated": "2011-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "RPH 53062",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marina del Rey, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.