Dr Mira Surjanto, PHARMD - Pharmacist in Vallejo, CA

Dr Mira Surjanto, PHARMD is a Pharmacist based in Vallejo, California. Dr Mira Surjanto is licensed to practice in California (license number 51280) and her current practice location is 975 Sereno Dr, Mob Medicine 7, Vallejo, California. She can be reached at her office (for appointments etc.) via phone at (707) 651-2584.

NPI number for Dr Mira Surjanto is 1124110705 and her current mailing address is 975 Sereno Dr, Mob Medicine 7, Vallejo, California. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1124110705.

Contact Information

Dr Mira Surjanto, PHARMD
975 Sereno Dr, Mob Medicine 7,
Vallejo, CA 94589-2441
(707) 651-2584
Not Available

Healthcare Provider's Profile

Full NameDr Mira Surjanto
GenderFemale
SpecialityPharmacist
Location975 Sereno Dr, Vallejo, California
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1124110705
  • Provider Enumeration Date: 09/29/2006
  • Last Update Date: 07/08/2007

Medical Identifiers

Medical identifiers for Dr Mira Surjanto such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1124110705NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
183500000XPharmacist 51280 (California)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Mira Surjanto is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Mira Surjanto, PHARMD
975 Sereno Dr, Mob Medicine 7,
Vallejo, CA 94589-2441

Ph: () -
Dr Mira Surjanto, PHARMD
975 Sereno Dr, Mob Medicine 7,
Vallejo, CA 94589-2441

Ph: (707) 651-2584

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› Verified 7 days ago


Pharmacist in Vallejo, CA

Rihong Zhou,
Pharmacist
Medicare: Not Enrolled in Medicare
Practice Location: 975 Sereno Dr, Vallejo, CA 94589
Phone: 707-651-2072    
Christina Crowley,
Pharmacist
Medicare: Not Enrolled in Medicare
Practice Location: 1193 Admiral Callaghan Ln, Vallejo, CA 94591
Phone: 707-552-0496    
Dr. Lindsey Rich, PHARMD
Pharmacist
Medicare: Not Enrolled in Medicare
Practice Location: 975 Sereno Dr, Inpatient Pharmacy, Vallejo, CA 94589
Phone: 707-651-2072    
Ms. Grace H Le, PHARM.D
Pharmacist
Medicare: Not Enrolled in Medicare
Practice Location: 975 Sereno Dr, Medicine 8, Vallejo, CA 94589
Phone: 707-651-4265    Fax: 707-651-2821
Michelle Gandley, RPH
Pharmacist
Medicare: Not Enrolled in Medicare
Practice Location: 122 Robles Way, Vallejo, CA 94591
Phone: 707-554-6908    Fax: 707-554-2347
Lily Phuong, PHARM.D
Pharmacist
Medicare: Not Enrolled in Medicare
Practice Location: 975 Sereno Dr, Vallejo, CA 94589
Phone: 707-651-5403    
Hieu Minh Phan, PHARMD
Pharmacist
Medicare: Not Enrolled in Medicare
Practice Location: 300 Hospital Dr, Vallejo, CA 94589
Phone: 707-554-5050    Fax: 707-554-5111

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