NPIMap

Organization Active NPI

Paseo Pharmacy LTD

  • Community/Retail Pharmacy
  • Pasadena, CA
National Provider Identifier
1104800457
Registry record updated Feb 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY 51907 Issued in CA
Legal business name
PASEO PHARMACY LTD
Practice address
2237 E Colorado Blvd
B104
Pasadena, CA 91107-3650
Phone
(626) 564-1000
Fax
(626) 583-8833
NPI assigned
Nov 30, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2015

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

Authorized official

Name
Mr. Andre Saroughian
Title
President/Owner
Phone
(626) 564-1000

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PHY 51907 CA
Community/Retail Pharmacy 3336C0003X PHY 51907 CA Primary
Compounding Pharmacy 3336C0004X PHY 51907 CA

Addresses

Primary practice location

2237 E Colorado Blvd
B104
Pasadena, CA 91107-3650

Mailing address

2237 E Colorado Blvd
B104
Pasadena, CA 91107-3650
Phone (626) 564-1001

Other identifiers 2

IdentifierTypeStateIssuer
05-66325OtherCANCPDP
PHY 51907OtherCABOARD OF PHARMACY PERMIT

Other names 1

  • PASEO PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Paseo Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

2237 E Colorado Blvd
Ste 104B
Pasadena, CA 91107
Phone (626) 564-1000

NPI Registry JSON

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423094400000",
    "number": "1104800457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2237 E COLORADO BLVD",
            "address_2": "B104",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911073650",
            "telephone_number": "626-564-1001",
            "fax_number": "626-583-8833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2237 E COLORADO BLVD",
            "address_2": "B104",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911073650",
            "telephone_number": "626-564-1000",
            "fax_number": "626-583-8833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASEO PHARMACY LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-30",
        "last_updated": "2015-02-05",
        "status": "A",
        "authorized_official_last_name": "SAROUGHIAN",
        "authorized_official_first_name": "ANDRE",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "626-564-1000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "PHY 51907",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY 51907",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "CA",
            "license": "PHY 51907",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "05-66325",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY PERMIT",
            "identifier": "PHY 51907",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PASEO PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2015; 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.