Individual provider Active NPI

Anabelle Victoria Gantman, PHARM.D.

  • Pharmacist
  • Los Angeles, CA
National Provider Identifier
1790518058
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
89849 Issued in CA
Practice address
1025 W 34TH St Ste 105
Los Angeles, CA 90089-0128
Phone
(213) 821-6100
NPI assigned
Aug 22, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 89849 CA Primary

Addresses

Primary practice location

1025 W 34TH St Ste 105
Los Angeles, CA 90089-0128

Mailing address

603 S 5TH Ave Unit C
Arcadia, CA 91006-4091
Phone (626) 774-6261

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

LicenseStateTypeSpecialty
89849CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Southern California CurrentSince Aug 25, 2024 Accepting new patients

Locations

1025 W 34th St
Ste 105
Los Angeles, CA 90089
Phone (213) 740-2738

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1724284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1790518058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 S 5TH AVE UNIT C",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910064091",
            "telephone_number": "626-774-6261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 W 34TH ST STE 105",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900890128",
            "telephone_number": "213-821-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANTMAN",
        "first_name": "ANABELLE",
        "middle_name": "VICTORIA",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-22",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "89849",
            "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 Aug 22, 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.

Verify at the official NPI Registry.