Mario Alfredo Jimenez, PHARM. D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

RPH31058 Issued in CA

Practice address

14300 Ramona Blvd
Baldwin Park, CA 91706-3241

Phone

(626) 337-1550

Fax

(626) 337-0660

NPI assigned

Sep 30, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Mr. Mario Alfredo Jimenez Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Locations

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.

• M a Jimenez Inc

  dba Knoll's Prescription Pharmacy

  • Durable Medical Equipment & Medical Supplies
  • Baldwin Park, CA
  • NPI 1053596452
  NPD Authorized official

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

{
    "created_epoch": "1159574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198022400000",
    "number": "1891888111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14300 RAMONA BLVD",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917063241",
            "telephone_number": "626-337-1550",
            "fax_number": "626-337-0660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14300 RAMONA BLVD",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917063241",
            "telephone_number": "626-337-1550",
            "fax_number": "626-337-0660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "MARIO",
        "middle_name": "ALFREDO",
        "name_prefix": "Mr.",
        "credential": "PHARM. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-30",
        "last_updated": "2007-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH31058",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "0975410001",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA358020",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIO",
            "last_name": "JIMENEZ",
            "middle_name": "ALFREDO",
            "prefix": "MR.",
            "credential": "PHARM.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bobbie L. Jahan-Parwar, MD
• Monica Marie Jaimes, LMFT
• Amy Yie Zen Jan, MD
• Jennifer Jang, M.D.
• JDS Medical Billing Services
• Sergio Jimenez, DPT
• Jeff S. Jo, MD
• Sandra Yvonne Joens
• Joey J Spitzer
• Bervic B. Johns, MD

• Pharmacist in Baldwin Park, CA
• Providers in Baldwin Park, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; 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.