MEDICARE: DR. WALTER JEROME PREVOST SR. PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	25903	CA

General Provider Information

NPI Number	:	1629035621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WALTER JEROME PREVOST SR. PHARM.D.

Provider Business Mailing Address
First Line	:	16709 AMBERWOOD WAY
Second Line	:
City	:	CERRITOS
State	:	CA
Zip	:	90703-1190
Country	:	US
Telephone Number	:	323-564-3218
Fax Number	:	323-564-4064

Provider Business Practice Location Address
First Line	:	9909 COMPTON AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90002-2850
Country	:	US
Telephone Number	:	323-564-3218
Fax Number	:	323-564-4064

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	07/08/2007

Similar Medicare Providers

1619965357 — PREVOST HEALTHCARE ENTERPRISES INC
Practice Location Address:

9909 COMPTON AVE
LOS ANGELES, CA
90002-2850

Practice Phone: 323-564-3218
Practice Fax: 323-564-4064

1235289679 — DR. HAGOS HABTEZGHI MD
Practice Location Address:

9901 COMPTON AVE
LOS ANGELES, CA
90002-2850

Practice Phone: 323-835-8401
Practice Fax: 323-835-8405

1811257363 — HAGOS HABTEZGHI, MD MEDICAL CORPORATION
Practice Location Address:

9901 COMPTON AVE
LOS ANGELES, CA
90002-2850

Practice Phone: 323-835-8401
Practice Fax: 323-835-8405

1073468054 — NIKHITA SHARAN BASAPPA
Practice Location Address:

945 WEYBURN TER
LOS ANGELES, CA
90024-2850

Practice Phone: 424-440-5637
Practice Fax:

1184896847 — YUE LI OMD
Practice Location Address:

5182 KATELLA AVE STE 103A
LOS ALAMITOS, CA
90720-2850

Practice Phone: 562-936-1980
Practice Fax: 562-936-1981

1215495023 — JOYFUL CARE CAREGIVING SERVICES, INC.
Practice Location Address:

5182 KATELLA AVE STE 103A
LOS ALAMITOS, CA
90720-2850

Practice Phone: 562-402-1890
Practice Fax: 562-865-6453

Directions to “ DR. WALTER JEROME PREVOST SR. PHARM.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.