Provider Demographics
NPI:1710097175
Name:HYGIEIA HEALTHCARE INC
Entity Type:Organization
Organization Name:HYGIEIA HEALTHCARE INC
Other - Org Name:LOS ALAMITOS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:VIDHYUT
Authorized Official - Middle Name:GIRISH
Authorized Official - Last Name:JANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-604-6630
Mailing Address - Street 1:3801 KATELLA AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-3360
Mailing Address - Country:US
Mailing Address - Phone:562-431-2505
Mailing Address - Fax:562-596-6226
Practice Address - Street 1:3801 KATELLA AVE STE 120
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3360
Practice Address - Country:US
Practice Address - Phone:562-431-2505
Practice Address - Fax:562-596-6226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2022-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
CAPHY362443336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1710097175Medicaid
CA0504236OtherNCPDP
CAPHA362440Medicaid