NPIMap

Organization Active NPI

Vista Pharmacies, Inc

  • Community/Retail Pharmacy
  • Paramount, CA
National Provider Identifier
1972604577
Registry record updated Nov 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY45064 Issued in CA
Legal business name
VISTA PHARMACIES, INC
Practice address
15717 Paramount Blvd
Paramount, CA 90723
Phone
(562) 630-8044
NPI assigned
Sep 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2011

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

Authorized official

Name
San Diem Le, PHARMD
Title
Pharmacist in Charge
Phone
(562) 630-8044

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHY45064 CA Primary

Addresses

Primary practice location

15717 Paramount Blvd
Paramount, CA 90723

Mailing address

15717 Paramount Blvd
Paramount, CA 90723
Phone (562) 630-8044

Other identifiers 2

IdentifierTypeStateIssuer
PHA450640MedicaidCA
0559483OtherCANCPDP

Other names 1

  • Paramount Vista Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Vista Pharmacies Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322611200000",
    "number": "1972604577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15717 PARAMOUNT BLVD",
            "city": "PARAMOUNT",
            "state": "CA",
            "postal_code": "90723",
            "telephone_number": "562-630-8044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15717 PARAMOUNT BLVD",
            "city": "PARAMOUNT",
            "state": "CA",
            "postal_code": "90723",
            "telephone_number": "562-630-8044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTA PHARMACIES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2011-11-30",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "SAN",
        "authorized_official_middle_name": "DIEM",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "562-630-8044",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY45064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA450640",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "0559483",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Paramount Vista Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Paramount, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2011; 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.