NPIMap

Organization Active NPI

El Mirador Medical Plaza Pharmacy Inc

Doing business as Desert Hospital Outpatient Ambulatory Health

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Palm Springs, CA
National Provider Identifier
1629651682
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
Legal business name
EL MIRADOR MEDICAL PLAZA PHARMACY INC
Doing business as
Desert Hospital Outpatient Ambulatory Health
Practice address
1180 N Indian Canyon Dr Ste E140
Palm Springs, CA 92262-4883
Phone
(760) 323-1001
Fax
(760) 323-1144
NPI assigned
Apr 28, 2021
Last updated
Apr 28, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
EL MIRADOR MEDICAL PLAZA PHARMACY INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

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

Authorized official

Name
Mr. Ramesh Upadhyayula, RPHNPI 1467775619
Title
President/Ceo
Phone
(760) 323-1001

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 1835P0018X Primary

Addresses

Primary practice location

1180 N Indian Canyon Dr Ste E140
Palm Springs, CA 92262-4883

Mailing address

1180 N Indian Canyon Dr Ste E140
Palm Springs, CA 92262-4883
Phone (760) 323-1001

Other practice location 1

3975 Jackson St Ste 109
Riverside, CA 92503-3946
Phone (951) 637-0180

Other practice location 2

422 N San Jacinto St
Hemet, CA 92543-3124
Phone (951) 305-5500

Other identifiers 1

IdentifierTypeStateIssuer
1861504854MedicaidCA

Other names 1

  • Desert Hospital Outpatient Ambulatory Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
El Mirador Medical Plaza PH9 organizations share this tax ID, including this one
Part of
El Mirador Medical Plaza PH

Other organizations with this tax ID 8

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

Locations

1180 N Indian Canyon Dr
Ste E140
Palm Springs, CA 92262
Phone (760) 323-1001

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619568000000",
    "number": "1629651682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 N INDIAN CANYON DR STE E140",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922624883",
            "telephone_number": "760-323-1001",
            "fax_number": "760-323-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 N INDIAN CANYON DR STE E140",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922624883",
            "telephone_number": "760-323-1001",
            "fax_number": "760-323-1144"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3975 Jackson St Ste 109",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925033946",
            "country_code": "US",
            "telephone_number": "951-637-0180",
            "fax_number": "951-637-0183",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "422 N San Jacinto St",
            "address_purpose": "LOCATION",
            "city": "Hemet",
            "state": "CA",
            "postal_code": "925433124",
            "country_code": "US",
            "telephone_number": "951-305-5500",
            "fax_number": "951-305-5505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EL MIRADOR MEDICAL PLAZA PHARMACY INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EL MIRADOR MEDICAL PLAZA PHARMACY INC.",
        "enumeration_date": "2021-04-28",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A",
        "authorized_official_last_name": "UPADHYAYULA",
        "authorized_official_first_name": "RAMESH",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "760-323-1001",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861504854",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Desert Hospital Outpatient Ambulatory Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palm Springs, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; 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.