Organization
MEDICAL PAVILION PHARMACY, INC.
Active
Other names
Medical Pavilion Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JASMINE BASRAI (CEO)
(408) 842-2001
Entity
Organization
Contact information
Practice address
9460 NO NAME UNO, SUITE 100, GILROY, CA 95020-3537
(408) 842-2001
(408) 842-7141
Mailing address
9460 NO NAME UNO, SUITE 100, GILROY, CA 95020-3537
(408) 842-2001
(408) 842-7141
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
47105
BOARD OF PHARMACY PERMIT
CA
Enumeration date
01/29/2007
Last updated
02/07/2019
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