Active NPI
Nima Kohanghadosh, PHARMD
- Pharmacist
- Los Angeles, CA
National Provider Identifier
1790296903
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 68430
- Practice address
- 1820 Westwood Blvd
Los Angeles, CA 90025-4612 - Phone
- (310) 475-6000
- Fax
- (310) 475-2890
- NPI assigned
- Oct 14, 2017
- Last updated
- Oct 31, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 68430 | CA | Primary |
Addresses
Primary practice location
1820 Westwood Blvd
Los Angeles, CA 90025-4612
Mailing address
1820 Westwood Blvd
Los Angeles, CA 90025-4612
Phone (310) 475-6000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 68430 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| La Pharmacy, Inc. | Current | Accepting new patients | |
| Imperial of Westwood Pharmacy | Past | Accepting new patients | |
| Garfield Beach CVS LLC | Past | Accepting new patients |
Locations
1820 Westwood Blvd
Los Angeles, CA 90025
Phone (310) 475-6000
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Retail Pharmacy
- Los Angeles, CA
- NPI 1023219664
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730332800000",
"number": "1790296903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1820 WESTWOOD BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900254612",
"telephone_number": "310-475-6000",
"fax_number": "310-475-2890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1820 WESTWOOD BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900254612",
"telephone_number": "310-475-6000",
"fax_number": "310-475-2890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOHANGHADOSH",
"first_name": "NIMA",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-10-14",
"last_updated": "2024-10-31",
"certification_date": "2024-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "68430",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.