Provider Type Icon

NASIBADARA INC NPI 1124122841


NPI Information

NPI: 1124122841
Provider Name: NASIBADARA, INC

Former Legal Business Name: EL TORO PHARMACY

Classification: Pharmacy - 333600000X
Entity Type: Organization

CLIA Number: 05D2145692

Address:
23665 MOULTON PKWY STE A&C
LAGUNA HILLS, CA
ZIP 92653
Phone: (949) 586-3664
Get Directions

NASIBADARA, INC is a pharmacy in Laguna Hills, CA. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. NASIBADARA, INC NPI is 1124122841. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is El Toro Pharmacy.

The provider's business location address is:

23665 MOULTON PKWY STE A&C
LAGUNA HILLS, CA
ZIP 92653-937
Phone: (949) 586-3664
Fax: (949) 580-1723

The provider's authorized official is Stewart Edington .
The authorized official title is Owner and has the following contact phone number (954) 818-6813.

The CLIA number assigned to this NPI record is 05D2145692 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/12/2006 and was last updated on 1/24/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
2333600000XPharmacyPHY55801CALIFORNIAYes
33336M0002XPharmacyMail Order PharmacyNo
43336S0011XPharmacySpecialty PharmacyNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1PHA44808MEDICAIDCALIFORNIA
21997867OTHERPK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.