Active NPI
Maryna Blom, RPH
- Pharmacist
- Poway, CA
National Provider Identifier
1508203506
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 51668
- Practice address
- 15644 Pomerado Rd
Suite 303
Poway, CA 92064-2400 - Phone
- (858) 726-2614
- Fax
- (858) 312-1130
- NPI assigned
- May 30, 2013
- 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 | 51668 | CA | Primary |
Addresses
Primary practice location
15644 Pomerado Rd
Suite 303
Poway, CA 92064-2400
Mailing address
15644 Pomerado Rd
Suite 303
Poway, CA 92064-2400
Phone (858) 726-2614
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pacifico West RX, Inc. | Past | Accepting new patients | |
| Thrive RX Specialty Pharmacy Corporation | 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 and National Provider Directory roles.
-
dba Mydrexa Compounding Pharmacy
- Pharmacy
- Poway, CA
- NPI 1467882779
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369872000000",
"number": "1508203506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15644 POMERADO RD",
"address_2": "SUITE 303",
"city": "POWAY",
"state": "CA",
"postal_code": "920642400",
"telephone_number": "858-726-2614",
"fax_number": "858-312-1130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15644 POMERADO RD",
"address_2": "SUITE 303",
"city": "POWAY",
"state": "CA",
"postal_code": "920642400",
"telephone_number": "858-726-2614",
"fax_number": "858-312-1130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLOM",
"first_name": "MARYNA",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-30",
"last_updated": "2013-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "51668",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Poway, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.