Active NPI
Charles Fann
- Pharmacist
- Los Angeles, CA
National Provider Identifier
1447129556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 57852
- Practice address
- 12607 Indianapolis St
Los Angeles, CA 90066-1513 - Phone
- (626) 242-8778
- NPI assigned
- Nov 5, 2025
- 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 | 57852 | CA | Primary |
Addresses
Primary practice location
12607 Indianapolis St
Los Angeles, CA 90066-1513
Mailing address
8700 Beverly Blvd
West Hollywood, CA 90048-1804
Phone (626) 242-8778
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 |
|---|---|---|---|
| 57852 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1762300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762300800000",
"number": "1447129556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8700 BEVERLY BLVD",
"city": "WEST HOLLYWOOD",
"state": "CA",
"postal_code": "900481804",
"telephone_number": "626-242-8778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12607 INDIANAPOLIS ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900661513",
"telephone_number": "626-242-8778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FANN",
"first_name": "CHARLES",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-11-05",
"last_updated": "2025-11-05",
"certification_date": "2025-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "57852",
"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 Nov 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.