BOONAM SHIN (NPI# 1821137118) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821137118 |
| Entity Type | Organization |
| Organization Name | BOONAM SHIN |
| Other Organization Name | 111 PHARMACY |
| Practice Address |
111 W Beverly Blvd Ste B Montebello CA 90640-4312 |
| Practice Telephone | 3237248111 |
| Practice Fax Number | 3237241754 |
| Mailing Telephone | 3237248111 |
| Mailing Fax Number | 3237241754 |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2011-05-27 |
| Authorized Official Name | BOONAM SHIN (OWNER) |
| Authorized Official Telephone | 3237428111 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHY41023 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER | 0523008 | 01 | |
| CA | PHA410230 | 05 |
| Other Name | Type Code |
|---|---|
| 111 PHARMACY | Doing Business As Name - Organization |
| Street Address |
111 W BEVERLY BLVD STE B |
| City | MONTEBELLO |
| State | CA |
| Zip Code | 90640-4312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215918743 | Lisandro Quinones | Internal Medicine | 111 W Beverly Blvd, Suite 208, Montebello, CA 90640-4312 | 2005-11-10 |
| 1225312218 | Savitri K Rambhatla, M.d, Inc | Pediatrics | 111 W Beverly Blvd, Suite # 220, Montebello, CA 90640-4312 | 2011-10-07 |
| 1205023850 | Beverly Oncology & Imaging Medical Group, Inc. | Radiology | 111 W Beverly Blvd, 104, Montebello, CA 90640-4312 | 2007-09-27 |
| 1811029929 | Stephen Y. Lee, M.d. Inc. | Specialist | 111 W Beverly Blvd, Suite 227, Montebello, CA 90640-4312 | 2007-03-12 |
| 1326116211 | Casa Cardenas | Community/Behavioral Health | 111 W Beverly Blvd, Suite 209, Montebello, CA 90640-4312 | 2006-12-01 |
| 1437225455 | Brennan Lloyd Hughes | Dentist | 111 W Beverly Blvd, Suite C, Montebello, CA 90640 | 2006-11-28 |
| 1053413351 | George Caballero | Social Worker | 111 W Beverly Blvd, Suite 209, Montebello, CA 90640-4312 | 2006-09-05 |
| 1548231251 | Montebello Dialysis Center, LLC | Clinic/Center | 111 W Beverly Blvd, A, Montebello, CA 90640-4312 | 2006-01-30 |
| 1891772026 | Stephen Y Lee | Specialist | 111 W Beverly Blvd, Suite #227, Montebello, CA 90640-4312 | 2005-12-29 |
| 1285616987 | Boonam Shin | Pharmacist | 111 W Beverly Blvd, Suite B, Montebello, CA 90640-4312 | 2005-11-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184242901 | Marie-christine Wiltord | Marriage & Family Therapist | 1447 W. Beverly Blvd., Montebello, CA 90640 | 2020-07-08 |
| 1366093668 | Ana Lesly Tavira-nava | Student in an Organized Health Care Education/Training Program | 3316 W. Beverly Blvd., Montebello, CA 90640 | 2019-09-27 |
| 1952803256 | America Alaniz | Marriage & Family Therapist | 3524 1/4 W. Beverly Blvd., Montebello, CA 90640 | 2018-03-02 |
| 1669987913 | Tender Loving Hospice Care, Inc. | Hospice Care, Community Based | 3528 W Beverly Blvd, Suite D, Montebello, CA 90640 | 2017-12-08 |
| 1518472869 | Healing Angels Nursing Services, Inc. | Home Health | 3538 W Beverly Blvd, Suite C, Montebello, CA 90640 | 2017-12-08 |
| 1427579143 | Paul Gonzales | Specialist/Technologist | 1525 Via Palermo, Montebello, CA 90640 | 2017-07-03 |
| 1942720859 | Rachel Lu | Pharmacist | 800 W. Whittier Blvd., Montebello, CA 90640 | 2017-06-21 |
| 1194254508 | Jill Tanigawa | Pharmacist | 2525 W Via Campo, Montebello, CA 90640 | 2017-06-08 |
| 1619406121 | Nutrition Care Consulting | Dietitian, Registered | 2605 Beverly Blvd, Montebello, CA 90640 | 2017-06-08 |
| 1992165815 | Hope Artificial Limb & Brace,llc | Prosthetic/Orthotic Supplier | 2609 W. Beverly Blvd #3, Montebello, CA 90640 | 2016-03-04 |
| Find all providers in zip 90640 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| 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. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427584044 | Pharma Group, Inc. | Pharmacy | 825 Washington Blvd Ste C, Montebello, CA 90640-6179 | 2017-05-02 |
| 1790158350 | Emerald Healthcare Pharmacy Corp | Pharmacy | 3414 W Beverly Blvd, Montebello, CA 90640-1539 | 2015-11-04 |
| 1952789216 | Verbatim & Associates LLC | Pharmacy | 2210 W Beverly Blvd, Montebello, CA 90640-2302 | 2015-05-07 |
| 1265863914 | Marc 1 Drugs Inc | Pharmacy | 2506 W Beverly Blvd, Montebello, CA 90640-2308 | 2013-12-05 |
| 1932499605 | C.n. Health, Inc. | Pharmacy | 1417 W Beverly Blvd Ste 103, Montebello, CA 90640-4146 | 2011-04-14 |
| 1285657627 | American Medical Pharmacy | Pharmacy | 2601 W Beverly Blvd, Montebello, CA 90640-2309 | 2006-07-26 |
| 1609327691 | Cedra Pharmacy Los Angeles LLC | Pharmacy | 1417 W Beverly Blvd, Montebello, CA 90640-4123 | 2016-10-14 |
| 1710318035 | Marc 1 Drugs Inc | Pharmacy | 1417 W Beverly Blvd, Montebello, CA 90640-4123 | 2013-12-12 |
| 1780615500 | Beverly Hi Medical Pharmacy | Pharmacy | 1428 W Beverly Blvd, Montebello, CA 90640-4147 | 2006-07-06 |
| 1043202146 | Healthy Medications, LLC | Pharmacy | 101 E Beverly Blvd, #101, Montebello, CA 90640-4300 | 2005-08-16 |
| Find all providers in MONTEBELLO | ||||
| City | MONTEBELLO |
| Zip Code | 90640 |
Please comment or provide details below to improve the information on BOONAM SHIN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.