NPIMap

Organization Active NPI

Bravo Pharmacy LLC

  • Community/Retail Pharmacy
  • Los Angeles, CA
National Provider Identifier
1912233644
Registry record updated May 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY 53315 Issued in CA
Legal business name
BRAVO PHARMACY LLC
Doing business as
Bravo Pharmacy
Practice address
7316 Compton Ave
Los Angeles, CA 90001-2532
Phone
(323) 586-9828
Fax
(323) 589-2174
NPI assigned
Oct 30, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2022

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

Authorized official

Name
Mr. Fred K Cho, RPHNPI 1205015625
Title
Member/Pic
Phone
(323) 586-9828

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHY 53315 CA Primary

Addresses

Primary practice location

7316 Compton Ave
Los Angeles, CA 90001-2532

Mailing address

7316 Compton Ave
Los Angeles, CA 90001-2532
Phone (323) 586-9828

Other identifiers 3

IdentifierTypeStateIssuer
1912233644MedicaidCA
5636343OtherNCPDP PROVIDER IDENTIFICATION NUMBER
PHY 53315OtherCASTATE BOARD OF PHARMACY PERMIT

Other names 1

  • Bravo Pharmacy Doing business as

National Provider Directory

National Provider Directory

Locations

7316 Compton Ave
Los Angeles, CA 90001
Phone (323) 586-9828

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1256860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652054400000",
    "number": "1912233644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7316 COMPTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900012532",
            "telephone_number": "323-586-9828",
            "fax_number": "323-589-2174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7316 COMPTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900012532",
            "telephone_number": "323-586-9828",
            "fax_number": "323-589-2174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAVO PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-30",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A",
        "authorized_official_last_name": "CHO",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MEMBER/PIC",
        "authorized_official_telephone_number": "323-586-9828",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY 53315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1912233644",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5636343",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD OF PHARMACY PERMIT",
            "identifier": "PHY 53315",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bravo Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bravo 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 May 9, 2022; 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.