Perla Anai Aispuro Vidana

Individual provider Active NPI Pharmacist · Inglewood, CA

NPI 1508601006 · NPPES record last updated Jun 26, 2024

Key facts

NPI
1508601006
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
89414 (CA)
Practice address
4345 W Century Blvd
Inglewood, CA 90304-1519
Phone
(310) 672-6078
NPI assigned
Jun 26, 2024
Sex
Female
Sole proprietor
Yes

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Garfield Beach CVS, L.L.C. Past
since Jun 30, 2024
Accepting new patients
Garfield Beach CVS LLC Past
since Jun 30, 2024
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 89414 CA Yes

Addresses

Primary practice location

4345 W Century Blvd
Inglewood, CA 90304-1519

Mailing address

1940 Orchard Ave
Los Angeles, CA 90007-1227
Phone (818) 573-8789

Other providers in Inglewood, CA

All providers in Inglewood, CA · Pharmacist in California

Sources for this page

Verify at the official NPI Registry.