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EL MIRADOR MEDICAL PLAZA PHARMACY INC NPI 1629651682


NPI Information

NPI: 1629651682
Provider Name: EL MIRADOR MEDICAL PLAZA PHARMACY INC
Classification: Pharmacist - 1835P0018X
Entity Type: Organization

Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Address:
1180 N INDIAN CANYON DR STE E140
PALM SPRINGS, CA
ZIP 92262
Phone: (760) 323-1001
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EL MIRADOR MEDICAL PLAZA PHARMACY INC is a pharmacist clinician (phc)/ clinical pharmacy specialist pharmacist in Palm Springs, CA. The provider is pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. EL MIRADOR MEDICAL PLAZA PHARMACY INC NPI is 1629651682. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1180 N INDIAN CANYON DR STE E140
PALM SPRINGS, CA
ZIP 92262-883
Phone: (760) 323-1001
Fax: (760) 323-1144

The provider's authorized official is Ramesh Upadhyayula .
The authorized official title is President/ceo and has the following contact phone number (760) 323-1001.

The enumeration date for this NPI number is 4/28/2021 and was last updated on 4/28/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11835P0018XPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11861504854MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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