Organization Active NPI

Gilbert Mathieu

  • Community/Retail Pharmacy
  • Los Angeles, CA
National Provider Identifier
1891909909
Registry record updated Jul 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY17947 Issued in CA
Legal business name
GILBERT MATHIEU
Practice address
4729 S Western Ave
Los Angeles, CA 90062-2321
Phone
(323) 299-9812
Fax
(323) 295-5481
NPI assigned
May 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2008

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

Authorized official

Name
Mr. Gilbert Anthony Mathieu, RPH
Title
Owner Pharmacist
Phone
(323) 299-9812

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHY17947 CA Primary

Addresses

Primary practice location

4729 S Western Ave
Los Angeles, CA 90062-2321

Mailing address

4729 S Western Ave
Los Angeles, CA 90062-2321
Phone (323) 299-9812

Other identifiers 1

IdentifierTypeStateIssuer
PHA179470MedicaidCA

Other names 1

  • Handler Pharmacy Doing business as

National Provider Directory

National Provider Directory

Locations

4729 S Western Ave
Los Angeles, CA 90062
Phone (323) 299-9812

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215043200000",
    "number": "1891909909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4729 S WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900622321",
            "telephone_number": "323-299-9812",
            "fax_number": "323-295-5481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4729 S WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900622321",
            "telephone_number": "323-299-9812",
            "fax_number": "323-295-5481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GILBERT MATHIEU",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2008-07-03",
        "status": "A",
        "authorized_official_last_name": "MATHIEU",
        "authorized_official_first_name": "GILBERT",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER PHARMACIST",
        "authorized_official_telephone_number": "323-299-9812",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY17947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA179470",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Handler Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2008; 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.