Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
SOUTH GATE ROSE PHCY INC
Active
Organization
SOUTH GATE ROSE PHCY INC
Active
Other names
BLUE ROSE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JAVIER ZAMORA (CFO)
(714) 350-3009
Entity
Organization
Contact information
Practice address
8615 KNOTT AVE, STE 7, BUENA PARK, CA 90620-3841
(714) 952-4978
(714) 953-6868
Mailing address
8615 KNOTT AVE, STE 7, BUENA PARK, CA 90620-3841
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
PHY47605
CA
3336L0003X
Long Term Care Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5622990
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/10/2006
Last updated
09/11/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers