NPIMap

Organization Active NPI

Medical Plaza Pharmacy Inc

  • Community/Retail Pharmacy
  • Palo Alto, CA
National Provider Identifier
1972615086
Registry record updated May 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY45166 Issued in CA
Legal business name
MEDICAL PLAZA PHARMACY INC
Practice address
211 Quarry Rd Ste 108
Palo Alto, CA 94304-1416
Phone
(650) 326-2300
Fax
(650) 326-2351
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2023

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

Authorized official

Name
Jonathan Han
Title
Chief Operating Officer
Phone
(650) 412-4555

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHY45166 CA Primary
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

211 Quarry Rd Ste 108
Palo Alto, CA 94304-1416

Mailing address

420 Industrial Rd
San Carlos, CA 94070-6286
Phone (650) 412-4555

Other identifiers 2

IdentifierTypeStateIssuer
1997900OtherPK
PHY45166MedicaidCA

Other names 1

  • Hoover Pharmacy Doing business as

National Provider Directory

National Provider Directory

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

1101 Welch Rd
Ste C12
Palo Alto, CA 94304
Phone (650) 326-2300

211 Quarry Rd
Ste 108
Palo Alto, CA 94304
Phone (650) 326-2300

420 Industrial Rd
San Carlos, CA 94070
Phone (650) 412-4530

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684281600000",
    "number": "1972615086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 INDUSTRIAL RD",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940706286",
            "telephone_number": "650-412-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 QUARRY RD STE 108",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041416",
            "telephone_number": "650-326-2300",
            "fax_number": "650-326-2351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL PLAZA PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A",
        "authorized_official_last_name": "HAN",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "650-412-4555"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY45166",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1997900",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHY45166",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hoover Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palo Alto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.