Active NPI
Imperial Beach Pharmacy LLC
- Specialty Pharmacy
- San Diego, CA
National Provider Identifier
1134038953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialty Pharmacy
- Legal business name
- IMPERIAL BEACH PHARMACY LLC
- Practice address
- 1530 Palm Ave
San Diego, CA 92154-1016 - Phone
- (619) 343-0095
- Fax
- (619) 830-4590
- NPI assigned
- Sep 7, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Prashant Amrutlal Koyani
- Title
- Owner
- Phone
- (619) 343-0095
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Infusion Therapy Pharmacy | 3336H0001X | |||
| Specialty Pharmacy | 3336S0011X | Primary |
Addresses
Primary practice location
1530 Palm Ave
San Diego, CA 92154-1016
Mailing address
1530 Palm Ave
San Diego, CA 92154-1016
Phone (619) 343-0095
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788739200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1788825600000",
"number": "1134038953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1530 PALM AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921541016",
"telephone_number": "619-343-0095",
"fax_number": "619-830-4590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1530 PALM AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921541016",
"telephone_number": "619-343-0095",
"fax_number": "619-830-4590"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "IMPERIAL BEACH PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-09-07",
"last_updated": "2026-09-08",
"certification_date": "2026-09-08",
"status": "A",
"authorized_official_last_name": "KOYANI",
"authorized_official_first_name": "PRASHANT",
"authorized_official_middle_name": "AMRUTLAL",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "619-343-0095"
},
"taxonomies": [
{
"code": "3336H0001X",
"taxonomy_group": "",
"desc": "Pharmacy, Home Infusion Therapy Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336S0011X",
"taxonomy_group": "",
"desc": "Pharmacy, Specialty Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
- Impact Medical Associates California
- Impedimed Inc
- Shannon Imper, LMFT
- Imperial Beach Community Clinic
- Imperial Beach Optometric Corporation
- Imperial Beach Pharmacy LLC
- Imperial Beach Pharmacy LLC
- Imperial Medical Health Care Group, Inc
- Imperial Medical Transport Inc
- Imperial Valley Optometric Corporation
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.