Pacific Healthcare Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY50436 Issued in CA

Legal business name

PACIFIC HEALTHCARE INC

Practice address

1907 Sunnycrest Dr
Fullerton, CA 92835-3626

Phone

(714) 871-8190

Fax

(714) 871-1339

NPI assigned

Oct 3, 2006

Organization subpart

No

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

Authorized official

Name

Hyun J Ro, PHARMD

Title

Owner

Phone

(714) 705-6355

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Sunny Hills Pharmacy Doing business as

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Gemmel Pharmacy Inc

  • Community/Retail Pharmacy
  • Los Angeles, CA
  • NPI 1174700660

  Member Of

  NPD member
• Octagon Healthcare Inc

  • Community/Retail Pharmacy
  • West Covina, CA
  • NPI 1902142664

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498780800000",
    "number": "1902990302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2271 W MALVERN AVE",
            "address_2": "368",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928332106",
            "telephone_number": "714-705-6355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 SUNNYCREST DR",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353626",
            "telephone_number": "714-871-8190",
            "fax_number": "714-871-1339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2017-06-30",
        "status": "A",
        "authorized_official_last_name": "RO",
        "authorized_official_first_name": "HYUN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-705-6355",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY50436",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA504360",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2128038",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunny Hills Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brett Owens
• Keyana Monet Owens, BA
• Payton Rainey Owens
• Sade Owney
• Destiny Pacheco
• Jay Packer, M.D.
• Andrea Padilla
• Celia Padilla
• Erika Padilla
• Rachel Padilla

• Community/Retail Pharmacy in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2017; 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.