Active NPI
Edward Dean Olaes, RPH
- Pharmacist
- Cerritos, CA
National Provider Identifier
1417471186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 76621
- Practice address
- 17916 Holmes Ave
Cerritos, CA 90703-8917 - Phone
- (954) 612-1887
- NPI assigned
- Aug 3, 2017
- Sex
- Male
- 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 | 76621 | CA | Primary |
Addresses
Primary practice location
17916 Holmes Ave
Cerritos, CA 90703-8917
Mailing address
1250 W Court St Apt 403
Los Angeles, CA 90026-7359
Phone (954) 612-1887
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
| License | State | Type | Specialty |
|---|---|---|---|
| 76621 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1417471186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1250 W COURT ST APT 403",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900267359",
"telephone_number": "954-612-1887"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17916 HOLMES AVE",
"city": "CERRITOS",
"state": "CA",
"postal_code": "907038917",
"telephone_number": "954-612-1887"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLAES",
"first_name": "EDWARD",
"middle_name": "DEAN",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-08-03",
"last_updated": "2022-07-21",
"certification_date": "2021-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "76621",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cerritos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.