Olive Tree Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY52415 Issued in CA

Legal business name

OLIVE TREE PHARMACY INC

Practice address

14124 Foothill Blvd Ste 102
Sylmar, CA 91342-8053

Phone

(818) 364-5100

Fax

(818) 364-5102

NPI assigned

Nov 21, 2014

Organization subpart

No

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

Authorized official

Name

William ZenNPI 1386963551

Title

Owner / Pic

Phone

(818) 364-5100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Olive Tree Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

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

• William Zen, PHARM.D.

  • Pharmacist
  • San Dimas, CA
  • NPI 1386963551
  NPD Authorized official
• Paul Sango Kim, RPH

  • Pharmacist
  • Murrieta, CA
  • NPI 1689252389
  NPD
• Trang Tran, PHARMD

  • Pharmacist
  • Sylmar, CA
  • NPI 1053901223
  NPD (past)

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

{
    "created_epoch": "1416528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445385600000",
    "number": "1447657358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14124 FOOTHILL BLVD",
            "address_2": "STE 102",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913428049",
            "telephone_number": "818-364-5100",
            "fax_number": "818-364-5102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14124 FOOTHILL BLVD STE 102",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913428053",
            "telephone_number": "818-364-5100",
            "fax_number": "818-364-5102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVE TREE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-21",
        "last_updated": "2015-10-21",
        "status": "A",
        "authorized_official_last_name": "ZEN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER / PIC",
        "authorized_official_telephone_number": "818-364-5100"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY52415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2148979",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Olive Tree Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tracy Marie Ogundele, PSYD
• Charlene Oh, MD
• Karen Ohanessian, PHAMD
• Johanna Alyssa Quiambao Ojeda, OTD, OTR/L
• Trudy N Olins, NP
• Avelina Flores Olson
• Lissette Olvera
• Michelle Adesola Omisore
• Omnilectic Therapy Collective, a Licensed Clinical Social Worker Corporation
• Owen Omoregie

• Community/Retail Pharmacy in Sylmar, CA
• Providers in Sylmar, 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 Oct 21, 2015; 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.