Kohana Pharmacy and Center for Regenerative Medicine Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

50264 Issued in CA

Legal business name

KOHANA PHARMACY AND CENTER FOR REGENERATIVE MEDICINE INC

Practice address

181 Tank Farm Rd Ste 120
San Luis Obispo, CA 93401-7082

Phone

(805) 542-0864

Fax

(805) 542-0867

NPI assigned

Mar 11, 2010

Organization subpart

No

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

Authorized official

Name

Robert Quinn, PHARMDNPI 1427434638

Title

Pharmacist

Phone

(805) 542-0864

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Kohana Pharmacy and Center for Regenerative Medicine Doing business as

Locations

Practitioners 3

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

• Robert Denis Quinn, PHARMD

  • Pharmacist
  • San Luis Obispo, CA
  • NPI 1427434638
  NPD (past) Authorized official
• Ami Grace Quinn, MSW, L.C.S. W., PPS

  • Clinical Social Worker
  • San Luis Obispo, CA
  • NPI 1710013529
  NPD (past)
• Anthony William Sinconis, PHARM D

  • Pharmacist
  • San Diego, CA
  • NPI 1760886394
  NPD (past)

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

{
    "created_epoch": "1268265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423526400000",
    "number": "1982927323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 TANK FARM RD",
            "address_2": "SUITE 120",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934017080",
            "telephone_number": "805-542-0864",
            "fax_number": "805-542-0867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 TANK FARM RD STE 120",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934017082",
            "telephone_number": "805-542-0864",
            "fax_number": "805-542-0867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOHANA PHARMACY AND CENTER FOR REGENERATIVE MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-11",
        "last_updated": "2015-02-10",
        "status": "A",
        "authorized_official_last_name": "QUINN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "805-542-0864",
        "authorized_official_credential": "PHARMD"
    },
    "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": "50264",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2124185",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kohana Pharmacy and Center for Regenerative Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jenny Ko
• Jonah Koch
• Abriel Kochar, MS, CCC-SLP
• Mark Koenig
• Rachael Koenig
• Corinne Rose Kohlen, R.D.
• Allison Kokonas
• Aemon James Kolasienski, PT
• Luke Koll
• Kolofer Chiropractic Inc.

• Community/Retail Pharmacy in San Luis Obispo, CA
• Providers in San Luis Obispo, 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 Feb 10, 2015; 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.