Individual provider Active NPI

John Grant O'Brien, PHARMD

  • Pharmacotherapy Pharmacist
  • San Jose, CA
National Provider Identifier
1770615452
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
License
45683 Issued in CA
Practice address
2400 Moorpark Ave
Suite 316B, Ira Greene Pace Clinic
San Jose, CA 95128-2631
Phone
(408) 885-7615
Fax
(408) 885-4699
NPI assigned
Mar 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacotherapy Pharmacist 1835P1200X 45683 CA Primary

Addresses

Primary practice location

2400 Moorpark Ave
Suite 316B, Ira Greene Pace Clinic
San Jose, CA 95128-2631

Mailing address

6146 Calle Esperanza
San Jose, CA 95120-4406
Phone (408) 323-1524

Other names 1

  • John Grant O'Brien Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Physician Assistant, Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
45683CAMDPharmacotherapy Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
University Foot and Ankle Institute a Podiatric Surgical Center Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770615452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6146 CALLE ESPERANZA",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951204406",
            "telephone_number": "408-323-1524",
            "fax_number": "408-885-4699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 MOORPARK AVE",
            "address_2": "SUITE 316B, IRA GREENE PACE CLINIC",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282631",
            "telephone_number": "408-885-7615",
            "fax_number": "408-885-4699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "JOHN",
        "middle_name": "GRANT",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "CA",
            "license": "45683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHN",
            "last_name": "O'BRIEN",
            "middle_name": "GRANT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.