NPIMap

Organization Active NPI

Park Medical Pharmacy

Doing business as Medical Center Pharmacy

  • Pharmacist
  • San Diego, CA
National Provider Identifier
1891808127
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH24623 Issued in CA
Legal business name
PARK MEDICAL PHARMACY
Doing business as
Medical Center Pharmacy
Practice address
610 Gateway Center Way
Suite a
San Diego, CA 92102-4533
Phone
(619) 238-9501
Fax
(619) 398-2929
NPI assigned
Aug 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Mr. George Awad
Title
Owner
Phone
(619) 262-4373

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 183500000X RPH24623 CA Primary
PharmacistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 183500000X PHY 46278 CA

Addresses

Primary practice location

610 Gateway Center Way
Suite a
San Diego, CA 92102-4533

Mailing address

610 Gateway Center Way
Suite a
San Diego, CA 92102-4533
Phone (619) 238-9501

Other identifiers 2

IdentifierTypeStateIssuer
PHY46278OtherCAPHARMACY LICENSE
PHA462780MedicaidCA

Other names 1

  • Medical Center Pharmacy Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1891808127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 GATEWAY CENTER WAY",
            "address_2": "SUITE A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024533",
            "telephone_number": "619-238-9501",
            "fax_number": "619-398-2929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 GATEWAY CENTER WAY",
            "address_2": "SUITE A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024533",
            "telephone_number": "619-238-9501",
            "fax_number": "619-398-2929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK MEDICAL PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "AWAD",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-262-4373",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH24623",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "PHY 46278",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE",
            "identifier": "PHY46278",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA462780",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • 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.