NPIMap

Organization Active NPI

San Gabriel Valley Medical Center

  • Long Term Care Pharmacy
  • San Gabriel, CA
National Provider Identifier
1366484909
Registry record updated Jun 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
PHY48932 Issued in CA
Legal business name
SAN GABRIEL VALLEY MEDICAL CENTER
Practice address
438 W Las Tunas Dr
San Gabriel, CA 91776-1216
Phone
(626) 570-6640
Fax
(626) 457-7153
NPI assigned
Jun 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2013

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

Authorized official

Name
Houshang Abd
Title
Cfo
Phone
(626) 570-0612

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Institutional Pharmacy 3336I0012X
Long Term Care Pharmacy 3336L0003X PHY48932 CA Primary

Addresses

Primary practice location

438 W Las Tunas Dr
San Gabriel, CA 91776-1216

Mailing address

438 W Las Tunas Dr
San Gabriel, CA 91776-1216
Phone (626) 570-6640

Other identifiers 1

IdentifierTypeStateIssuer
2094550OtherPK

Other names 1

  • SAN GABRIEL VALLEY MEDICAL CENTER Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ahmc San Gabriel Valley Medical Center LP4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/sangab-372b8737

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371945600000",
    "number": "1366484909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "438 W LAS TUNAS DR",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761216",
            "telephone_number": "626-570-6640",
            "fax_number": "626-457-7153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "438 W LAS TUNAS DR",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761216",
            "telephone_number": "626-570-6640",
            "fax_number": "626-457-7153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN GABRIEL VALLEY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2013-06-23",
        "status": "A",
        "authorized_official_last_name": "ABD",
        "authorized_official_first_name": "HOUSHANG",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "626-570-0612"
    },
    "taxonomies": [
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "CA",
            "license": "PHY48932",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2094550",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAN GABRIEL VALLEY MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Gabriel, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2013; 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.