Cda Clinical Pharmacy Corporation

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY 53298 Issued in CA

Legal business name

CDA CLINICAL PHARMACY CORPORATION

Doing business as

CDA CLINICAL PHARMACY

Practice address

11441 Heacock St
Ste D
Moreno Valley, CA 92557-7907

Phone

(951) 242-2540

Fax

(951) 242-1490

NPI assigned

Jul 22, 2015

Organization subpart

No

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

Authorized official

Name

Ms. Amelia Grace Padilla

Title

Ceo/RPH

Phone

(951) 242-2540

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• CDA CLINICAL PHARMACY Doing business as

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

{
    "created_epoch": "1437523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438041600000",
    "number": "1649655457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11441 HEACOCK ST",
            "address_2": "STE D",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925577907",
            "telephone_number": "951-242-2540",
            "fax_number": "951-242-1490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11441 HEACOCK ST",
            "address_2": "STE D",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925577907",
            "telephone_number": "951-242-2540",
            "fax_number": "951-242-1490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CDA CLINICAL PHARMACY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-22",
        "last_updated": "2015-07-28",
        "status": "A",
        "authorized_official_last_name": "PADILLA",
        "authorized_official_first_name": "AMELIA",
        "authorized_official_middle_name": "GRACE",
        "authorized_official_title_or_position": "CEO/RPH",
        "authorized_official_telephone_number": "951-242-2540",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY 53298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA STATE BOARD OF PHARMACY",
            "identifier": "PHY53298",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CDA CLINICAL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jaaval Shaune Cato
• Benjamin John Caudill, RN, MSN, FNP-C
• Lanicee Causly
• Bonnie Cazares
• Rafael Cazares, LMFT
• CDH, Inc.
• Garett Cecchini, MD
• Elizabeth Ceja Manzo
• Celestial Senior Living LLC
• Brandon Cendejas, PA-C

• Community/Retail Pharmacy in Moreno Valley, CA
• Providers in Moreno Valley, 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 28, 2015; 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.