NPIMap

Organization Active NPI

SD Pharmcare Inc

  • Community/Retail Pharmacy
  • Los Angeles, CA
National Provider Identifier
1992851083
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY56188 Issued in CA
Legal business name
SD PHARMCARE INC
Practice address
461 S Western Ave
Los Angeles, CA 90020-4102
Phone
(213) 480-3322
Fax
(213) 401-0002
NPI assigned
Jan 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Authorized official

Name
Jeong Mook Choi, PHARM D.
Title
Cfo
Phone
(213) 480-3322

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHY56188 CA Primary

Addresses

Primary practice location

461 S Western Ave
Los Angeles, CA 90020-4102

Mailing address

461 S Western Ave
Los Angeles, CA 90020-4102
Phone (213) 480-3322

Other identifiers 2

IdentifierTypeStateIssuer
0592053OtherOTHER ID NUMBER
PHA360000MedicaidCA

Other names 1

  • 986 Pharmacy #8038 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210120002615 CA Part B Supplier - Mass Immunization (Roster Biller Only) 0941614663 Practice locations: Los Angeles, CA
O20260119000351 CA Part B Supplier - Mass Immunization (Roster Biller Only) 7315424686 Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory
Tax ID family
986 Pharmacy 80382 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

461 S Western Ave
Los Angeles, CA 90020
Phone (213) 480-3322

Practitioners & affiliated clinicians

Practitioners 4

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": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760313600000",
    "number": "1992851083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 S WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900204102",
            "telephone_number": "213-480-3322",
            "fax_number": "213-401-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 S WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900204102",
            "telephone_number": "213-480-3322",
            "fax_number": "213-401-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SD PHARMCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A",
        "authorized_official_last_name": "CHOI",
        "authorized_official_first_name": "JEONG",
        "authorized_official_middle_name": "MOOK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "213-480-3322",
        "authorized_official_credential": "PHARM D."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY56188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "0592053",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA360000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "986 Pharmacy #8038",
            "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 Oct 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.