Active NPI
Michelle M Kwon, R.PH
- Pharmacist
- Los Angeles, CA
National Provider Identifier
1972881043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 43163
- Practice address
- 1075 N Western Ave
117
Los Angeles, CA 90029-2307 - Phone
- (323) 465-3112
- NPI assigned
- Jul 23, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 43163 | CA | Primary |
Addresses
Primary practice location
1075 N Western Ave
117
Los Angeles, CA 90029-2307
Mailing address
2072 Lyans Dr
La Canada, CA 91011-1537
Phone (818) 248-0408
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 313963 | Other | CA | NABP |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 43163 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CNS Pharmacy Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Retail Pharmacy
- Los Angeles, CA
- NPI 1699078725
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311379200000",
"number": "1972881043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2072 LYANS DR",
"city": "LA CANADA",
"state": "CA",
"postal_code": "910111537",
"telephone_number": "818-248-0408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1075 N WESTERN AVE",
"address_2": "117",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900292307",
"telephone_number": "323-465-3112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KWON",
"first_name": "MICHELLE",
"middle_name": "M",
"credential": "R.PH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-07-23",
"last_updated": "2011-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "43163",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NABP",
"identifier": "313963",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}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 23, 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.