NPIMap

Organization Active NPI

Los Angeles LGBT Center

Doing business as Jeffrey Goodman Special Care Pharmacy

  • Community/Retail Pharmacy
  • Los Angeles, CA
National Provider Identifier
1437160637
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY-45118 Issued in CA
Legal business name
LOS ANGELES LGBT CENTER
Doing business as
Jeffrey Goodman Special Care Pharmacy
Practice address
1625 Schrader Blvd
1St Floor
Los Angeles, CA 90028-6213
Phone
(323) 993-7513
Fax
(323) 308-4444
NPI assigned
Aug 11, 2006
Last updated
Sep 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Authorized official

Name
Robyn Goldman
Title
Chief Financial Officer
Phone
(323) 993-8948

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHY-45118 CA Primary

Addresses

Primary practice location

1625 Schrader Blvd
1St Floor
Los Angeles, CA 90028-6213

Mailing address

1625 Schrader Blvd
1St Floor
Los Angeles, CA 90028-6213
Phone (323) 993-7513

Other identifiers 2

IdentifierTypeStateIssuer
05-34099OtherCANABP #
PHA 45118MedicaidCA

Other names 1

  • Jeffrey Goodman Special Care Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241008003668 CA Part B Supplier - Pharmacy 8729975453 Practice locations: Los Angeles, CA

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Los Angeles LGBT Center7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1625 Schrader Blvd
Fl 1
Los Angeles, CA 90028
Phone (323) 993-7513

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

  • Tam Phan
    • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
    • Los Angeles, CA
    • NPI 1386128585
    NPD (past)

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727308800000",
    "number": "1437160637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 SCHRADER BLVD",
            "address_2": "1ST FLOOR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900286213",
            "telephone_number": "323-993-7513",
            "fax_number": "323-308-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 SCHRADER BLVD",
            "address_2": "1ST FLOOR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900286213",
            "telephone_number": "323-993-7513",
            "fax_number": "323-308-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOS ANGELES LGBT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A",
        "authorized_official_last_name": "GOLDMAN",
        "authorized_official_first_name": "ROBYN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "323-993-8948"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY-45118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP #",
            "identifier": "05-34099",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA 45118",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jeffrey Goodman Special Care Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.