Puresource Advanced Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

PURESOURCE ADVANCED INC

Doing business as

Mission Hills Pharmacy

Practice address

10630 Sepulveda Blvd
Ste 101
Mission Hills, CA 91345-1938

Phone

(818) 639-0108

Fax

(818) 639-0118

NPI assigned

Oct 3, 2016

Organization subpart

No

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

Authorized official

Name

Laura Luskin

Title

Owner

Phone

(818) 639-0108

Specialties & licenses 2

Addresses

Other names 1

• MISSION HILLS PHARMACY Doing business as

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

{
    "created_epoch": "1475452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657584000000",
    "number": "1528517547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10630 SEPULVEDA BLVD",
            "address_2": "STE 101",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913451938",
            "telephone_number": "818-639-0108",
            "fax_number": "818-639-0118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10630 SEPULVEDA BLVD",
            "address_2": "STE 101",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913451938",
            "telephone_number": "818-639-0108",
            "fax_number": "818-639-0118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURESOURCE ADVANCED INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-03",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A",
        "authorized_official_last_name": "LUSKIN",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-639-0108"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "55664",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MISSION HILLS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Samina Qadir, NP
• Tedmur Qozi-Habash, M.D.
• Evan Quick, PA-C
• Roxanne Quijano
• Rafael Eduardo Quinonez, M.D., PHD

• Community/Retail Pharmacy in Mission Hills, CA
• Providers in Mission Hills, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; 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.