Medical Pavilion Pharmacy, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

MEDICAL PAVILION PHARMACY, INC.

Practice address

9460 No Name Uno
Suite 100
Gilroy, CA 95020-3537

Phone

(408) 842-2001

Fax

(408) 842-7141

NPI assigned

Jan 29, 2007

Organization subpart

No

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

Authorized official

Name

Jasmine Basrai

Title

Ceo

Phone

(408) 842-2001

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Medical Pavilion Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• David Dong Kieu, PHARMD

  • Pharmacist
  • Gilroy, CA
  • NPI 1992005888
  NPD (past)

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549497600000",
    "number": "1205972254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9460 NO NAME UNO",
            "address_2": "SUITE 100",
            "city": "GILROY",
            "state": "CA",
            "postal_code": "950203537",
            "telephone_number": "408-842-2001",
            "fax_number": "408-842-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9460 NO NAME UNO",
            "address_2": "SUITE 100",
            "city": "GILROY",
            "state": "CA",
            "postal_code": "950203537",
            "telephone_number": "408-842-2001",
            "fax_number": "408-842-7141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL PAVILION PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2019-02-07",
        "status": "A",
        "authorized_official_last_name": "BASRAI",
        "authorized_official_first_name": "JASMINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "408-842-2001"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY PERMIT",
            "identifier": "47105",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Pavilion Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joseph Clarence McMurray, D.M.D.
• Shannon McRoberts
• Xinhua Li Meagher
• Patricia Mears
• Maria S Medel, MFTI
• Medical Pavilion Pharmacy, Inc.
• Arturo Medina
• Laura Marie Medina
• Marissa Maria Medina
• Vanessa Medrano-Ramirez

• Community/Retail Pharmacy in Gilroy, CA
• Providers in Gilroy, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.