Charles Keola Abellana

Individual provider Active NPI Pharmacy Technician · Pacifica, CA

NPI 1871294850 · NPPES record last updated Mar 15, 2023

Key facts

NPI
1871294850
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacy Technician 183700000X
License
TCH186885 (CA)
Practice address
200 Fairmont Shopping Ctr
Pacifica, CA 94044-1240
Phone
(650) 355-5810
Fax
(650) 355-5882
NPI assigned
Mar 15, 2023
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
TCH186885CAMDPharmacy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Thrifty Payless Inc Past
since Mar 19, 2023
Accepting new patients
Thrifty Payless Inc Past
since Mar 19, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X TCH186885 CA Yes

Addresses

Primary practice location

200 Fairmont Shopping Ctr
Pacifica, CA 94044-1240

Mailing address

200 Fairmont Shopping Ctr
Pacifica, CA 94044-1240
Phone (650) 355-5810

Other providers in Pacifica, CA

All providers in Pacifica, CA · Pharmacy Technician in California

Sources for this page

Verify at the official NPI Registry.