Individual provider Active NPI

Jason Kiroyan, PHARMD

  • Pharmacist
  • Rancho Mirage, CA
National Provider Identifier
1396210290
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
79355 Issued in CA
Practice address
72780 Country Club Dr Ste 403
Rancho Mirage, CA 92270-4149
Phone
(909) 647-7354
Fax
(760) 610-6512
NPI assigned
Oct 6, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 79355 CA Primary

Addresses

Primary practice location

72780 Country Club Dr Ste 403
Rancho Mirage, CA 92270-4149

Mailing address

72780 Country Club Dr Ste 403
Rancho Mirage, CA 92270-4149
Phone (909) 647-7354

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
79355CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Vivawell Pharmacy Company CurrentSince Feb 6, 2022 Accepting new patients
Vivawell Pharmacy Company CurrentSince May 16, 2022 Accepting new patients

Locations

72780 Country Club Dr
Ste 403
Rancho Mirage, CA 92270
Phone (760) 610-6512

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": "1538784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1396210290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72780 COUNTRY CLUB DR STE 403",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704149",
            "telephone_number": "909-647-7354",
            "fax_number": "760-610-6512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72780 COUNTRY CLUB DR STE 403",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704149",
            "telephone_number": "909-647-7354",
            "fax_number": "760-610-6512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIROYAN",
        "first_name": "JASON",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-06",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "79355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2026; 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.