Active NPI
Ethel Odiakosa, PHARMD
- Pharmacist
- Palm Springs, CA
National Provider Identifier
1861703225
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 61675
- Practice address
- 255 N El Cielo Rd
Suite C322
Palm Springs, CA 92262-6992 - Phone
- (760) 969-6560
- Fax
- (760) 328-2230
- NPI assigned
- Jun 30, 2010
- Sex
- Female
- Sole proprietor
- No
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 | 61675 | CA | Primary |
Addresses
Primary practice location
255 N El Cielo Rd
Suite C322
Palm Springs, CA 92262-6992
Mailing address
255 N El Cielo Rd
Suite C322
Palm Springs, CA 92262-6992
Phone (760) 969-6560
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 61675 | Other | CA | STATE LICENSE |
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 |
|---|---|---|---|
| 61675 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398384000000",
"number": "1861703225",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "255 N EL CIELO RD",
"address_2": "SUITE C322",
"city": "PALM SPRINGS",
"state": "CA",
"postal_code": "922626992",
"telephone_number": "760-969-6560",
"fax_number": "760-328-2230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 N EL CIELO RD",
"address_2": "SUITE C322",
"city": "PALM SPRINGS",
"state": "CA",
"postal_code": "922626992",
"telephone_number": "760-969-6560",
"fax_number": "760-328-2230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODIAKOSA",
"first_name": "ETHEL",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-30",
"last_updated": "2014-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "61675",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "61675",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Palm Springs, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.