Ceuticare LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

CEUTICARE LLC

Doing business as

Regal Specialty Pharmacy

Practice address

1875 California Ave Ste 101
Corona, CA 92881-6477

Phone

(951) 817-1005

Fax

(951) 817-1020

NPI assigned

Jan 12, 2018

Last updated

Oct 29, 2021By 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

Shirley Pham, RPHNPI 1407571631

Title

Owner/Pharmacy Manager

Phone

(951) 817-1005

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Regal Specialty Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shirley Pham, PHARMD

  • Pharmacist
  • Corona, CA
  • NPI 1407571631
  NPD Authorized official

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

{
    "created_epoch": "1515715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635465600000",
    "number": "1639687585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1875 CALIFORNIA AVE STE 101",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928816477",
            "telephone_number": "951-817-1005",
            "fax_number": "951-817-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 CALIFORNIA AVE STE 101",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928816477",
            "telephone_number": "951-817-1005",
            "fax_number": "951-817-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEUTICARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-12",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_title_or_position": "OWNER/PHARMACY MANAGER",
        "authorized_official_telephone_number": "951-817-1005",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "55935",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA BOARD OF PHARMACY",
            "identifier": "57876",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Regal Specialty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Aryana Marcela Cervantes
• Jorge Alberto Cervantes
• Roberta I Cervantes, RN, BSN, IBCLC
• Marielle Cabuhat Cesa, MAOT, OTR/L
• Cesar R. Bartell, O.D. Inc.
• Ceuticare LLC (Regal Specialty Pharmacy)
• CF Rodgers DDS Inc (Main Street Dental Group)
• Krystal Chaira
• Melissa Chalongwongse
• Chris VI Chan, PHARMD

• Community/Retail Pharmacy in Corona, CA
• Providers in Corona, 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 Oct 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.