Individual provider Active NPI

Daniel Toshihiko Fukumoto, PHARMD

  • Pharmacist
  • Los Angeles, CA
National Provider Identifier
1477073963
Registry record updated Jun 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
37405 Issued in CA
Practice address
CVS Pharmacy
9618 W. Pico Blvd
Los Angeles, CA 90035
Phone
(310) 858-1855
Fax
(310) 858-1070
NPI assigned
Jun 26, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 37405 CA Primary

Addresses

Primary practice location

CVS Pharmacy
9618 W. Pico Blvd
Los Angeles, CA 90035

Mailing address

4913 Paseo del Pavon
Torrance, CA 90505-6268
Phone (310) 483-5432

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
Doctor of Pharmacy

Practice roles

OrganizationSpecialtyStatusNew patients
Longs Drug Store California LLC Past Accepting new patients

Organizations & group practices 1

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": "1498435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498435200000",
    "number": "1477073963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4913 PASEO DEL PAVON",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905056268",
            "telephone_number": "310-483-5432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CVS PHARMACY",
            "address_2": "9618 W. PICO BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90035",
            "telephone_number": "310-858-1855",
            "fax_number": "310-858-1070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUKUMOTO",
        "first_name": "DANIEL",
        "middle_name": "TOSHIHIKO",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-26",
        "last_updated": "2017-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "37405",
            "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 Jun 26, 2017; 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.