NPIMap

Organization Active NPI

Stanford Health Care

  • Specialty Pharmacy
  • Palo Alto, CA
National Provider Identifier
1053835595
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Specialty PharmacyTaxonomy code 3336S0011X
Legal business name
STANFORD HEALTH CARE
Practice address
875 Blake Wilbur Dr Ste Cc1102
Palo Alto, CA 94304-2205
Phone
(650) 736-3800
Fax
(650) 736-7991
NPI assigned
Jul 26, 2017
Last updated
Oct 14, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
STANFORD HEALTH CAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Authorized official

Name
Hari Chandana Mulamalla, PHARMD
Title
Executive Director,Pharmacy Service
Phone
(312) 215-0088

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 55482 CA
Specialty Pharmacy 3336S0011X NU Primary

Addresses

Primary practice location

875 Blake Wilbur Dr Ste Cc1102
Palo Alto, CA 94304-2205

Mailing address

875 Blake Wilbur Dr Ste Cc1102
Palo Alto, CA 94304-2205
Phone (650) 736-3800

Other identifiers 2

IdentifierTypeStateIssuer
2170491OtherPK
PENDINGMedicaidCA

Other names 1

  • Stanford Health Care Pharmacy Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20171130002094 CA DME Supplier - Pharmacy 6709797491 Practice locations: Palo Alto, CA
O20190710000077 CA Part B Supplier - Pharmacy 6709797491 2 other NPIs on this enrollment
Practice locations: Palo Alto, CA; Mountain View, CA

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Stanford Health Care Pharmacy875 Blake Wilbur Dr, Palo Alto, CA 94304-2205(650) 736-3800 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Jan 1, 1966

National Provider Directory

National Provider Directory
Part of
UCSF Stanford HLTH Care

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Stanford Health Care Tri-ValleyPleasanton, CA, CCN 050283 Hospital 5% Or Greater Direct Ownership Interest (100%) May 18, 2015
Stanford Health CareStanford, CA, CCN 050441 Hospital 5% Or Greater Direct Ownership Interest (100%) Feb 27, 2013
Stanford Health ServicesStanford, CA, CCN 05S441 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966

Owned or controlled facilities with NPI records 9

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1501027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760400000000",
    "number": "1053835595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 BLAKE WILBUR DR STE CC1102",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943042205",
            "telephone_number": "650-736-3800",
            "fax_number": "650-736-7991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 BLAKE WILBUR DR STE CC1102",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943042205",
            "telephone_number": "650-736-3800",
            "fax_number": "650-736-7991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STANFORD HEALTH CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STANFORD HEALTH CARE",
        "enumeration_date": "2017-07-26",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A",
        "authorized_official_last_name": "MULAMALLA",
        "authorized_official_first_name": "HARI CHANDANA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR,PHARMACY SERVICE",
        "authorized_official_telephone_number": "312-215-0088",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "55482",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2170491",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stanford Health Care Pharmacy",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Stanford Health Care Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.