NPIMap

Organization Active NPI

Los Angeles Christian Health Centers

Doing business as Pico Aliso Community Pharmacy

  • Community/Retail Pharmacy
  • Los Angeles, CA
National Provider Identifier
1770855132
Registry record updated May 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY49915 Issued in CA
Legal business name
LOS ANGELES CHRISTIAN HEALTH CENTERS
Doing business as
Pico Aliso Community Pharmacy
Practice address
1625 E 4TH St
Los Angeles, CA 90033-4201
Phone
(323) 268-8391
Fax
(858) 633-4702
NPI assigned
Feb 1, 2012
Last updated
May 7, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2021

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

Authorized official

Name
Bettina Lewis
Title
Coo
Phone
(213) 893-1960

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Clinic Pharmacy 3336C0002X NU
Community/Retail Pharmacy 3336C0003X PHY49915 CA Primary

Addresses

Primary practice location

1625 E 4TH St
Los Angeles, CA 90033-4201

Mailing address

1625 E 4TH St
Los Angeles, CA 90033-4201
Phone (323) 268-8391

Other identifiers 2

IdentifierTypeStateIssuer
1770855132MedicaidCA
2134659OtherPK

Other names 1

  • Pico Aliso Community Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Los Angeles Christian Health Centers14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1328054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620345600000",
    "number": "1770855132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 E 4TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900334201",
            "telephone_number": "323-268-8391",
            "fax_number": "858-633-4702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 E 4TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900334201",
            "telephone_number": "323-268-8391",
            "fax_number": "858-633-4702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOS ANGELES CHRISTIAN HEALTH CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-01",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "BETTINA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "213-893-1960"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY49915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770855132",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2134659",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pico Aliso Community Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pico Aliso Community Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2021; 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.