Provider Demographics
NPI:1881329795
Name:PIGNERI, BROOKE ALYSON (PHARMD)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:ALYSON
Last Name:PIGNERI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3941 VESELICH AVE APT 251
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90039-1491
Mailing Address - Country:US
Mailing Address - Phone:949-933-9325
Mailing Address - Fax:
Practice Address - Street 1:1515 N VERMONT AVE STE 237
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-5329
Practice Address - Country:US
Practice Address - Phone:323-783-3830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-24
Last Update Date:2022-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86327183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA86327OtherBOARD OF PHARMACY