Prashant Amrutlal Koyani, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

77902 Issued in CA

Practice address

1530 Palm Ave
San Diego, CA 92154-1016

Phone

(619) 343-0095

Fax

(619) 830-4590

NPI assigned

Jun 20, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Locations

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.

• Imperial Beach Pharmacy LLC

  • Community/Retail Pharmacy
  • San Diego, CA
  • NPI 1326652371
  NPD Authorized official
• Imperial Beach Pharmacy LLC

  • Long Term Care Pharmacy
  • San Diego, CA
  • NPI 1558125856
  NPD Authorized official

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

{
    "created_epoch": "1560988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1871153874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 PALM AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921541016",
            "telephone_number": "619-343-0095",
            "fax_number": "619-830-4590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 PALM AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921541016",
            "telephone_number": "619-343-0095",
            "fax_number": "619-830-4590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2295 N Imperial Ave",
            "address_purpose": "LOCATION",
            "city": "El Centro",
            "state": "CA",
            "postal_code": "922431335",
            "country_code": "US",
            "telephone_number": "760-482-5407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOYANI",
        "first_name": "PRASHANT",
        "middle_name": "AMRUTLAL",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-20",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS55807",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "77902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele Kowalski-McGraw, MD
• Dorothy Kowalski, B.A.
• Kristen Marie Kowalski, MOT OTR/L
• Nicole Lynn Kowalski, M.S., CCC-SLP
• H. Susan Kower, M.D.
• Kelly Koyano, RD
• Casey Kozak, MD
• Kevin Mark Kozakowski, DO
• Eliana L Kozin, BCH BAO
• Mary Lynne Koziorowski, CADC II

• Pharmacist in San Diego, CA
• Providers in San Diego, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; 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.