NPIMap

Individual provider Active NPI

Roy Isamu Miyashiro, PHARM D

  • Pharmacist
  • South Pasadena, CA
National Provider Identifier
1134429673
Registry record updated Nov 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
29811 Issued in CA
Practice address
1213 Fair Oaks Ave
South Pasadena, CA 91030-3805
Phone
(626) 799-4156
Fax
(626) 799-7391
NPI assigned
Nov 1, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 29811 CA Primary

Addresses

Primary practice location

1213 Fair Oaks Ave
South Pasadena, CA 91030-3805

Mailing address

1213 Fair Oaks Ave
South Pasadena, CA 91030-3805
Phone (626) 799-4156

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
29811CAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Vons Companies Inc Past Accepting new patients
Vons Companies Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1288569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288569600000",
    "number": "1134429673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 FAIR OAKS AVE",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910303805",
            "telephone_number": "626-799-4156",
            "fax_number": "626-799-7391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 FAIR OAKS AVE",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910303805",
            "telephone_number": "626-799-4156",
            "fax_number": "626-799-7391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIYASHIRO",
        "first_name": "ROY",
        "middle_name": "ISAMU",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-01",
        "last_updated": "2010-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "29811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2010; 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.