Individual provider Active NPI

Maryanne Obianuju Nwude

  • Pharmacist
  • Torrance, CA
National Provider Identifier
1922638972
Registry record updated Jan 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
66474 Issued in CA
Practice address
5020 W 190TH St
Torrance, CA 90503-1004
Phone
(310) 370-5607
NPI assigned
Jan 17, 2020
Last updated
Jan 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 66474 CA Primary

Addresses

Primary practice location

5020 W 190TH St
Torrance, CA 90503-1004

Mailing address

1016 Via Fortuna
Palos Verdes Estates, CA 90274-2721

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

State licenses

LicenseStateTypeSpecialty
66474CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Garfield Beach CVS LLC PastSince Jan 19, 2020 Accepting new patients
Garfield Beach CVS, L.L.C. PastSince Jan 19, 2020 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1579219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579219200000",
    "number": "1922638972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1016 VIA FORTUNA",
            "city": "PALOS VERDES ESTATES",
            "state": "CA",
            "postal_code": "902742721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5020 W 190TH ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905031004",
            "telephone_number": "310-370-5607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWUDE",
        "first_name": "MARYANNE",
        "middle_name": "OBIANUJU",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-17",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "66474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2020; 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.