Four Seasons Pharmacy Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

FOUR SEASONS PHARMACY INC

Practice address

7872 Walker St Ste 106
La Palma, CA 90623-1748

Phone

(714) 690-0349

Fax

(714) 509-1278

NPI assigned

Nov 2, 2011

Organization subpart

No

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

Authorized official

Name

Nathan Lam

Title

Ceo

Phone

(714) 690-0349

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• PHOENIX PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Han Sam Corp

  • Home Infusion Therapy Pharmacy
  • Irvine, CA
  • NPI 1508315128

  O20110419000305

  Same enrollment
• Han Sam Corp

  • Pharmacy
  • Palm Desert, CA
  • NPI 1689823486

  O20110419000305

  Same enrollment

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• United Medcare

  • Community/Retail Pharmacy
  • Los Angeles, CA
  • NPI 1245397512

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1320192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739318400000",
    "number": "1750667986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7872 WALKER ST STE 106",
            "city": "LA PALMA",
            "state": "CA",
            "postal_code": "906231748",
            "telephone_number": "714-690-0349",
            "fax_number": "714-509-1278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7872 WALKER ST STE 106",
            "city": "LA PALMA",
            "state": "CA",
            "postal_code": "906231748",
            "telephone_number": "714-690-0349",
            "fax_number": "714-509-1278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR SEASONS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-02",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A",
        "authorized_official_last_name": "LAM",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-690-0349"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750667986",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2132478",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHOENIX PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelli Anne Ferry
• Kylie Louise Figueroa
• Celia Shanika Ebilane Flores
• Maria Ruvalcaba Flores
• Four Seasons Pharmacy Inc
• Anthony Foye
• Codi Ki Fredrickson
• Sarah Elizabeth Freels
• Melanie Ann Freeman, MA, BCBA
• Friendly Eye Medical Group Inc

• Long Term Care Pharmacy in La Palma, CA
• Providers in La Palma, CA by specialty
• Long Term Care Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; 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.