Provider Demographics
NPI:1770819674
Name:LOS ALTOS PHARMACY AT EL CAMINO HOSPITAL
Entity Type:Organization
Organization Name:LOS ALTOS PHARMACY AT EL CAMINO HOSPITAL
Other - Org Name:LOS ALTOS PHARMACY AT EL CAMINO HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAPLINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:PHRMD
Authorized Official - Phone:650-962-5866
Mailing Address - Street 1:2500 GRANT RD
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-4302
Mailing Address - Country:US
Mailing Address - Phone:650-962-5866
Mailing Address - Fax:650-962-5866
Practice Address - Street 1:2500 GRANT RD STE 1B20
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4302
Practice Address - Country:US
Practice Address - Phone:650-962-5860
Practice Address - Fax:650-962-5866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-27
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY501533336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5636317OtherNCPDP PROVIDER IDENTIFICATION NUMBER