Mariposa Pharmacy LTD

Primary specialty

PharmacyTaxonomy code 333600000X

License

PHY52570 Issued in CA

Legal business name

MARIPOSA PHARMACY LTD

Practice address

2970 W Olympic Blvd # 104
Los Angeles, CA 90006-2518

Phone

(213) 365-5067

NPI assigned

Apr 18, 2015

Organization subpart

No

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

Authorized official

Name

Bill Park

Title

Ceo

Phone

(310) 720-1237

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1429315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429315200000",
    "number": "1861889735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2970 W OLYMPIC BLVD # 104",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900062518",
            "telephone_number": "213-365-5067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2970 W OLYMPIC BLVD # 104",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900062518",
            "telephone_number": "213-365-5067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIPOSA PHARMACY LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-18",
        "last_updated": "2015-04-18",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "BILL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-720-1237"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "PHY52570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Patrice Marion
• Frances Marion, LCSW
• Ingrid Thayana Mariona Gomez, MD
• Mariposa Detox Center II LLC
• Mariposa Detox Center LLC
• Adrianna Janette Mariscal
• Alondra Eleonor Mariscal
• Amanda Mariscal
• Lizet Mariscal
• Maykayla Melody Mariscal

• Pharmacy in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2015; 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.