Menlo Square Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY39968 Issued in CA

Legal business name

MENLO SQUARE PHARMACY

Practice address

1610 El Camino Real
Ste a
Menlo Park, CA 94025-4112

Phone

(650) 322-1888

Fax

(650) 322-1880

NPI assigned

Aug 20, 2006

Organization subpart

No

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

Authorized official

Name

Chester Yee

Title

Owner

Phone

(650) 322-1888

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• MENLO PARK PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202428800000",
    "number": "1336254366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 EL CAMINO REAL",
            "address_2": "STE A",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 EL CAMINO REAL",
            "address_2": "STE A",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254112",
            "telephone_number": "650-322-1888",
            "fax_number": "650-322-1880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENLO SQUARE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2008-02-08",
        "status": "A",
        "authorized_official_last_name": "YEE",
        "authorized_official_first_name": "CHESTER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "650-322-1888"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY39968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0525583",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA399680",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "0525583",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MENLO PARK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Menlo Park, CA
• Providers in Menlo Park, 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 8, 2008; 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.