EXCLUDEDPROVIDER
Entity Revocation

Pacifica Pharmacy Corp

Huntington Beach, CA 92648

Public HHS-OIG LEIE exclusion record

Pacifica Pharmacy Corp of Huntington Beach, CA is registered in the CMS NPI Registry under National Provider Identifier (NPI) 1639281553 with a primary specialty of Pharmacy, Community/Retail Pharmacy. According to the HHS-OIG List of Excluded Individuals/Entities (LEIE), Pacifica Pharmacy Corp is currently excluded from participation in federally funded health care programs due to license revocation, suspension, or surrender, as of May 20, 2014.

Status
Currently listed by HHS-OIG
Record type
Entity
Location
Huntington Beach, CA 92648
Exclusion date
May 20, 2014
Exclusion type
Revocation (1128b4)
NPI
1639281553

Record summary

Pacifica Pharmacy Corp appears in the HHS-OIG List of Excluded Individuals/Entities (LEIE) public dataset as an entity record associated with Huntington Beach, California. The latest imported LEIE dataset lists this record as currently excluded from participation in federally funded health care programs. The exclusion date shown in the source record is May 20, 2014, and the exclusion type is 1128b4, identified by HHS-OIG as license revocation, suspension, or surrender.

Source record

SourceHHS-OIG LEIE (public dataset)
Record typeEntity
Current statusCurrently listed by HHS-OIG
Exclusion dateMay 20, 2014
Exclusion typeLicense revocation, suspension, or surrender (1128b4)
NPI1639281553
Source dataset dateMay 2026

What this exclusion type means

HHS-OIG identifies exclusion type 1128b4 as “License revocation, suspension, or surrender.” License revocation, suspension, or surrender (permissive exclusion).

This exclusion type is a statutory category used by HHS-OIG in the LEIE dataset. The category describes the legal authority associated with the exclusion record, not a separate investigation or additional reporting by Excluded Provider.

Location and provider classification

This LEIE record is associated with Huntington Beach, CA 92648. The listed provider category is Other Business. The listed specialty is Pharmacy.

NPI Registry context

The LEIE record lists NPI 1639281553. CMS NPPES public registry data lists this NPI as an organization record with primary taxonomy Pharmacy, Community/Retail Pharmacy (3336C0003X). Registered practice location: Huntington Beach, CA. NPI enumeration date: Aug 31, 2006. NPPES status: Active.

NPI Registry data is administrative provider-identification data from CMS. It does not independently verify or explain the HHS-OIG exclusion record above. Verify exclusion status directly with HHS-OIG.

Other excluded providers in Huntington Beach, CA

Other individuals and entities currently listed in the HHS-OIG LEIE public dataset with a Huntington Beach, CA address.

Gary Lee Didio Individual Program Crime
Huntington Beach, CA · Conviction of program-related crimes · Excluded Mar 2026
Aurelio Ayala Individual Patient Abuse
Huntington Beach, CA · Conviction relating to patient abuse or neglect · Excluded Mar 2026
Sandrell Mitchell Individual Revocation
Huntington Beach, CA · License revocation, suspension, or surrender · Excluded Jan 2026
Bradley Davis Smith Individual Revocation
Huntington Beach, CA · License revocation, suspension, or surrender · Excluded Nov 2022
Michael Mario Santillanes Individual Revocation
Huntington Beach, CA · License revocation, suspension, or surrender · Excluded Sep 2022
Thomas Shelton Powers Individual Felony Fraud
Huntington Beach, CA · Felony conviction relating to health care fraud · Excluded Mar 2022
Michael Alan Rudolph Individual Revocation
Huntington Beach, CA · License revocation, suspension, or surrender · Excluded Oct 2021
Steven Frederick Jr Richardson Individual Drug Felony
Huntington Beach, CA · Felony conviction relating to controlled substance · Excluded Dec 2020

See all 42 excluded providers in Huntington Beach →

How to verify this record

This page is a public-record summary and should be treated as a possible LEIE match, not final identity verification. To verify the record, use the official HHS-OIG LEIE search and compare available identifying information through the official process. Name, location, provider category, specialty, exclusion date, and NPI should be treated as matching clues rather than final proof of identity.

What this page does not include

This page summarizes the HHS-OIG LEIE public dataset only. It does not search state Medicaid exclusion lists, state licensing-board actions, court records, malpractice records, employment history, civil lawsuits, or non-public investigations.

Verify with HHS-OIG Remove / correct this record

Related

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