Individual provider Active NPI

Dorian Christian Baucum, RPH

  • Pharmacist
  • Los Angeles, CA
National Provider Identifier
1902118961
Registry record updated Jul 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
61000 Issued in CA
Practice address
5575 Wilshire Boulevard
Los Angeles, CA 90036
Phone
(323) 954-7193
NPI assigned
Jul 7, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 61000 CA Primary

Addresses

Primary practice location

5575 Wilshire Boulevard
Los Angeles, CA 90036

Mailing address

5575 Wilshire Blvd
Los Angeles, CA 90036-3808
Phone (323) 954-7193

Other names 1

  • Mr. Dorian Christian Baucum Professional name

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
61000CAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Thrifty Payless Inc Past Accepting new patients
Thrifty Payless Inc Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1278460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278460800000",
    "number": "1902118961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5575 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900363808",
            "telephone_number": "323-954-7193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5575 WILSHIRE BOULEVARD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90036",
            "telephone_number": "323-954-7193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUCUM",
        "first_name": "DORIAN",
        "middle_name": "CHRISTIAN",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-07",
        "last_updated": "2010-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "61000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DORIAN",
            "last_name": "BAUCUM",
            "middle_name": "CHRISTIAN",
            "prefix": "MR.",
            "credential": "RPH",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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 7, 2010; 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.