SERRAND MEDICAL CENTER PHARMACY Full NPI Record 1013082783
Pharmacy in Los Angeles, CA

Complete NPI Dataset

The following table represents the complete NPI 1013082783 dataset for Serrand Medical Center Pharmacy in 4220 WEST 3RD ST SUITE #100 LOS ANGELES, CA 90020. The data table includes a list of all field names, values and definitions of the complete NPI record. The NPI dataset is available for download in CSV format using the "Download NPI" button below at the end of the table.

Name Value Definition
NPI1013082783The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code2Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EINUNAVAILThe Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Provider Organization Name Legal Business NameSERRAND MEDICAL CENTER PHARMACYThe name of the organization provider. If the provider is an organization, this is the legal business name.
Provider First Line Business Mailing Address4220 WEST 3RD STThe first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Second Line Business Mailing AddressSUITE #100The second line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider second line location address’’.
Provider Business Mailing Address City NameLOS ANGELESThe city name in the mailing address of the provider being identified.
Provider Business Mailing Address State NameCAThe State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code90020The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S USThe country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number2133813855The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number2133813856The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address4220 WEST 3RD STThe first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.


Provider Second Line Business Practice Location AddressSUITE #100The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameLOS ANGELESThe city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameCAThe State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code90020The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S USThe country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number2133813855The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number2133813856The fax number associated with the location address of the provider being identified.
Provider Enumeration Date11/21/2006The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date8/22/2020The date that a record was last updated or changed.
Authorized Official Last NamePARKThe last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameCHANGThe first name of the authorized official.
Authorized Official Middle NameKYUThe middle name of the authorized official.
Authorized Official Title or PositionOWNERThe title or position of the authorized official.
Authorized Official Telephone Number3104726308The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1333600000XCode designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1PHY21856The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1CAThe code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1Y
Other Provider Identifier 1AS9799480Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 101Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier Issuer 1US DEA
Other Provider Identifier 2PHY21856Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 201Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 2CA
Other Provider Identifier Issuer 2BOARD OF PHARMACY
Other Provider Identifier 3PHA218560Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 305Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 3CA
Is Organization SubpartN
Authorized Official Credential TextPHARM D