Individual provider Active NPI

Hersela Mirzatuny, PHARM D

  • Pharmacist
  • Mission Viejo, CA
National Provider Identifier
1962762468
Registry record updated May 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
66463 Issued in CA
Practice address
26836 Oso Pkwy Apt 2204
Mission Viejo, CA 92691-6053
Phone
(818) 804-1365
NPI assigned
May 18, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 66463 CA Primary

Addresses

Primary practice location

26836 Oso Pkwy Apt 2204
Mission Viejo, CA 92691-6053

Mailing address

26836 Oso Pkwy Apt 2204
Mission Viejo, CA 92691-6053
Phone (818) 804-1365

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
66463CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1337299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337299200000",
    "number": "1962762468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26836 OSO PKWY APT 2204",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916053",
            "telephone_number": "818-804-1365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26836 OSO PKWY APT 2204",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916053",
            "telephone_number": "818-804-1365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRZATUNY",
        "first_name": "HERSELA",
        "name_prefix": "Ms.",
        "credential": "PHARM D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-18",
        "last_updated": "2012-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "66463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2012; 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.