Organization Active NPI

Kelly Rosemead Pharmacy Inc

  • Community/Retail Pharmacy
  • Rosemead, CA
National Provider Identifier
1760543201
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
KELLY ROSEMEAD PHARMACY INC
Practice address
8901 E Valley Blvd
Rosemead, CA 91770-1831
Phone
(626) 286-2184
Fax
(626) 286-8043
NPI assigned
Dec 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Tai Cao Tran, PHARM D
Title
Pharm D President
Phone
(626) 286-2184

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

8901 E Valley Blvd
Rosemead, CA 91770-1831

Mailing address

8901 E Valley Blvd
Rosemead, CA 91770-1831
Phone (626) 286-2184

Other identifiers 1

IdentifierTypeStateIssuer
PHA371790MedicaidCA

Other names 1

  • Rosemead Pharmacy Doing business as

National Provider Directory

National Provider Directory

Locations

8901 Valley Blvd
Rosemead, CA 91770
Phone (626) 286-2184

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760543201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 E VALLEY BLVD",
            "city": "ROSEMEAD",
            "state": "CA",
            "postal_code": "917701831",
            "telephone_number": "626-286-2184",
            "fax_number": "626-286-8043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 E VALLEY BLVD",
            "city": "ROSEMEAD",
            "state": "CA",
            "postal_code": "917701831",
            "telephone_number": "626-286-2184",
            "fax_number": "626-286-8043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY ROSEMEAD PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "TAI",
        "authorized_official_middle_name": "CAO",
        "authorized_official_title_or_position": "PHARM D PRESIDENT",
        "authorized_official_telephone_number": "626-286-2184",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA371790",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rosemead Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rosemead, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.