Organization Active NPI

Mowry Plaza Pharmacy

  • Community/Retail Pharmacy
  • Fremont, CA
National Provider Identifier
1043356090
Registry record updated Aug 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY45452 Issued in CA
Legal business name
MOWRY PLAZA PHARMACY
Practice address
668 Mowry Ave
Fremont, CA 94536-4113
Phone
(510) 745-9900
Fax
(510) 745-9950
NPI assigned
Jan 29, 2007
Organization subpart
Yes
Parent organization
HALLER'S PHARMACY & MEDICAL SUPPLYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 5, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Gurpartap Singh Basrai, PHARM.D.
Title
Owner
Phone
(510) 745-9900

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 31057 CA
Community/Retail Pharmacy 3336C0003X PHY45452 CA Primary

Addresses

Primary practice location

668 Mowry Ave
Fremont, CA 94536-4113

Mailing address

668 Mowry Ave
Fremont, CA 94536-4113
Phone (510) 745-9900

Other identifiers 1

IdentifierTypeStateIssuer
PHA454520MedicaidCA

Other names 1

  • Gurpartap Singh Basrai Other name

National Provider Directory

National Provider Directory
Tax ID family
Washington Medical Phcy3 organizations share this tax ID, including this one
Part of
Washington Medical Phcy

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

668 Mowry Ave
Fremont, CA 94536
Phone (510) 745-9900

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217894400000",
    "number": "1043356090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "668 MOWRY AVE",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945364113",
            "telephone_number": "510-745-9900",
            "fax_number": "510-745-9950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "668 MOWRY AVE",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945364113",
            "telephone_number": "510-745-9900",
            "fax_number": "510-745-9950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOWRY PLAZA PHARMACY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HALLER'S PHARMACY & MEDICAL SUPPLY",
        "enumeration_date": "2007-01-29",
        "last_updated": "2008-08-05",
        "status": "A",
        "authorized_official_last_name": "BASRAI",
        "authorized_official_first_name": "GURPARTAP",
        "authorized_official_middle_name": "SINGH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-745-9900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "31057",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY45452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA454520",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gurpartap Singh Basrai",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.