Gordon's Fairview Pharmacy

Primary specialty

PharmacyTaxonomy code 333600000X

License

PHY46099 Issued in CA

Legal business name

GORDON'S FAIRVIEW PHARMACY

Practice address

2600 Walnut Ave Unit F
Tustin, CA 92780-7032

Phone

(714) 389-4826

Fax

(714) 389-4821

NPI assigned

Jan 4, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Sau Van Tran, RPH

Title

Ower

Phone

(714) 389-4826

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1558418152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 WALNUT AVE UNIT F",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927807032",
            "telephone_number": "714-389-4826",
            "fax_number": "714-389-4821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 WALNUT AVE UNIT F",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927807032",
            "telephone_number": "714-389-4826",
            "fax_number": "714-389-4821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORDON'S FAIRVIEW PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "SAU",
        "authorized_official_middle_name": "VAN",
        "authorized_official_title_or_position": "OWER",
        "authorized_official_telephone_number": "714-389-4826",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "PHY46099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE",
            "identifier": "PHY46099",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "0525494",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1558418152",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA460990",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Good Shephard Medical Clinic
• Good Shepherd Counseling Clinic
• Good Shepherd Medical Clinic, Inc
• Marappa V Gopinath, MD
• Lowell Andrew Gordon, M.D.
• David Richard Gorrie, D.C.
• Michelle Gorski, DPT
• Nazema Gosla, PA
• Rutuja Gourkar, NP
• Nikita Govind, DPT

• Pharmacy in Tustin, CA
• Providers in Tustin, CA by specialty
• Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.