Altadena Medical Pharmacy Incorporated

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

ALTADENA MEDICAL PHARMACY INCORPORATED

Practice address

2525 E Foothill Blvd Ste 6
Pasadena, CA 91107-3485

Phone

(626) 765-6246

Fax

(626) 765-6250

NPI assigned

Sep 5, 2023

Last updated

Sep 5, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gayane Danielyan

Title

President/Ceo

Phone

(626) 765-6246

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Tax ID family

Altadena Medical Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Altadena Medical Pharmacy Incorporated

  dba Altadena Medical Pharmacy

  • Long Term Care Pharmacy
  • Pasadena, CA
  • NPI 1790677631
  NPD tax ID

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

{
    "created_epoch": "1693872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693872000000",
    "number": "1457137689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 E FOOTHILL BLVD STE 6",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911073485",
            "telephone_number": "626-765-6246",
            "fax_number": "626-765-6250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 E FOOTHILL BLVD STE 6",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911073485",
            "telephone_number": "626-765-6246",
            "fax_number": "626-765-6250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTADENA MEDICAL PHARMACY INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-05",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A",
        "authorized_official_last_name": "DANIELYAN",
        "authorized_official_first_name": "GAYANE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "626-765-6246"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "PHY59172",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Menatallah Alsalamony
• Jenica Marie Alsaybar
• Katrina Alston
• Crystal Alstot, BCBA
• Altadena Hospice Care, Inc
• Altadena Medical Pharmacy Incorporated (Altadena Medical Pharmacy)
• Altadena Surgery Center, LLC
• Altamed Health Service Corpotation (Altamed Pharmacy Pasadenna)
• Altamed Health Services Corp (AltaMed Pharmacy Pasadena, Fair Oaks)
• Brenda R Altamirano

• Community/Retail Pharmacy in Pasadena, CA
• Providers in Pasadena, 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 Sep 5, 2023; 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.