Active NPI
Jason Kiroyan, PHARMD
- Pharmacist
- Rancho Mirage, CA
National Provider Identifier
1396210290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 79355
- 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
- Last updated
- Mar 10, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 79355 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vivawell Pharmacy Company | Current | Accepting new patients | |
| Vivawell Pharmacy Company | Current | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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.