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111 PHARMACY
NPI 1821137118
Pharmacy - Community/Retail Pharmacy in Montebello, CA

Active since February 05, 2007
111 W BEVERLY BLVD, STE B, MONTEBELLO, CA 90640(323) 724-8111(323) 724-1754 Get Directions Write a Review

NPPES record last updated: May 27, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About 111 Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

111 PHARMACY (NPI 1821137118) is a healthcare organization registered as a community/retail pharmacy in Montebello, California and active in the NPI registry since February 2007. The organization lists Boonam Shin, Owner, as its authorized official.

NPPES Registry Identity

NPI1821137118
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameBOONAM SHIN
Location Address111 W BEVERLY BLVD, STE BMontebello, CA 90640-4312
Mailing Address111 W Beverly Blvd, Ste BMontebello, CA 90640-4312 · (323) 724-8111 · Fax (323) 724-1754
Phone(323) 724-8111
Fax(323) 724-1754
Organization SubpartNo
Authorized OfficialBoonam ShinOwner · (323) 742-8111
Enumeration DateFebruary 5, 2007
Last NPPES UpdateMay 27, 2011
✔ NPI 1821137118 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in CA · PHY41023
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Also ListedPharmacyTaxonomy 333600000X
111 W BEVERLY BLVD, Montebello, CA 90640
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Other Names 1

Doing Business As111 Pharmacy

Other Identifiers 4

MedicaidPHA410230CA
Medicare NSC1158670001
Other0523008Other Id Number
Medicare NSC1821137118

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GEORGE CABALLERO MSW, LCSW
Social Worker (Clinical)
111 W BEVERLY BLVD, SUITE 209
MONTEBELLO, CA 90640
Los Angeles County (323) 255-9421
SAVITRI K RAMBHATLA, M.D, INC
Pediatrics (Neonatal-Perinatal Medicine)
111 W BEVERLY BLVD, SUITE # 220
MONTEBELLO, CA 90640
Los Angeles County (323) 726-6200
CASA CARDENAS
Community/Behavioral Health
111 W BEVERLY BLVD, SUITE 209
MONTEBELLO, CA 90640
Los Angeles County (626) 337-6650
STEPHEN Y. LEE, M.D. INC.
Specialist
111 W BEVERLY BLVD, SUITE 227
MONTEBELLO, CA 90640
Los Angeles County (323) 727-0367
STEPHEN Y LEE M.D.,FACOG
Specialist
111 W BEVERLY BLVD, SUITE #227
MONTEBELLO, CA 90640
Los Angeles County (323) 727-0367

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Boonam Shin's NPI number?

The NPI number for Boonam Shin is 1821137118. It was assigned to this organization in the NPPES registry on February 5, 2007. The provider is doing business as 111 Pharmacy.

Where is Boonam Shin located?

Boonam Shin is located at 111 W Beverly Blvd Ste B, Montebello, CA 90640. The listed phone number is (323) 724-8111.

What is Boonam Shin's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

When was this NPI record last updated?

The NPPES record for Boonam Shin was last updated on May 27, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.