IndividualActive
Miranda Boisclair, PHARMD
NPI 1619053154 · Geriatric Pharmacist · Los Angeles, CA
Provider details
- NPI number
- 1619053154
- Entity type
- Individual
- Primary specialty
- Geriatric PharmacistPharmacy Service Providers
- Credential
- PHARMD
- Sex
- Female
- Sole proprietor
- No
- License
- 011439 (SC)
Specialties & taxonomies
Pharmacy Service Providers
Practice location
11301 Wilshire Blvd Bldg 500
Los Angeles, CA 90073-1003
Phone: (310) 362-0179
Approximate (ZIP-level) locationGet directions
Mailing address
535 Gayley Ave Apt 207
Los Angeles, CA 90024-2040
Registry dates
- Enumerated
- 2006-10-27
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.