Laura Bautista Abernathy
Individual provider Active NPI Pharmacist · El Segundo, CA
NPI 1861618902 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1861618902
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RPH 53546 (CA)
- Practice address
- 220 E Grand Ave
El Segundo, CA 90245-3827 - Phone
- (310) 640-2715
- Fax
- (310) 640-0804
- NPI assigned
- Apr 17, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH 53546 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thrifty Payless Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH 53546 | CA | Yes |
Addresses
Primary practice location
220 E Grand Ave
El Segundo, CA 90245-3827
Mailing address
17615 Crabapple Way
Carson, CA 90746-7421
Phone (310) 640-2715
Other providers in El Segundo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.