Medpro Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY50438 Issued in CA

Legal business name

MEDPRO PHARMACY INC

Doing business as

Medpro Pharmacy

Practice address

7129 W Sunset Blvd
Los Angeles, CA 90046-4411

Phone

(323) 969-8300

Fax

(323) 969-8400

NPI assigned

Jul 11, 2006

Last updated

Aug 30, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Siavash Ahdoot, PHARM D

Title

President/Pharmacist

Phone

(323) 939-8300

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• MEDPRO PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314662400000",
    "number": "1639103807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7129 W SUNSET BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900464411",
            "telephone_number": "323-969-8300",
            "fax_number": "323-969-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7129 W SUNSET BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900464411",
            "telephone_number": "323-969-8300",
            "fax_number": "323-969-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDPRO PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2011-08-30",
        "status": "A",
        "authorized_official_last_name": "AHDOOT",
        "authorized_official_first_name": "SIAVASH",
        "authorized_official_title_or_position": "PRESIDENT/PHARMACIST",
        "authorized_official_telephone_number": "323-939-8300",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "PHY50438",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY50438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5622560",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD OF PHARMACY RETAIL PERMIT",
            "identifier": "PHY 50438",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639103807",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDPRO PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Medlink Healthcare Networks, Inc
• George Mednik, M.D.
• Tal Medovoy, ACSW
• Medpartners Healthcare, Inc.
• Medpoint Whole Health
• Medpros LLC
• Antonietta Medrano Bailey
• Veronica Medrano Gonzalez
• Mayra Alejandra Medrano-Trujillo
• Amelia R Medrano, LCSW

• Community/Retail Pharmacy in Los Angeles, CA
• Providers in Los Angeles, 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 Aug 30, 2011; 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.