San Jose Pharmacy, Inc.

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

License

24085532 Issued in CA

Legal business name

SAN JOSE PHARMACY, INC.

Practice address

222 W Eulalia St Ste 212
Glendale, CA 91204-2851

Phone

(818) 247-3266

Fax

(818) 247-3267

NPI assigned

Jul 13, 2006

Organization subpart

No

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

Authorized official

Name

Miss Tony Gale Walker, RPH

Title

Owner

Phone

(818) 247-3266

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214265600000",
    "number": "1912922741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13428 MAXELLA AVE # 193",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925620",
            "telephone_number": "818-247-3266",
            "fax_number": "818-247-3267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 W EULALIA ST STE 212",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042851",
            "telephone_number": "818-247-3266",
            "fax_number": "818-247-3267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JOSE PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2008-06-24",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "GALE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-247-3266",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "CA",
            "license": "24085532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Health Clinic/Center in Glendale, CA
• Providers in Glendale, CA by specialty
• Community Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2008; 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.