Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Mira Surjanto, PHARMD

Individual provider Pharmacist · NPI 1124110705

Dr. Mira Surjanto, PHARMD is a Pharmacist in Vallejo, California. Licensed in California. Registered with an NPI since 2006.

Licensed in
CA
In the registry since
2006
What do these letters mean?
PHARMD — Doctor of Pharmacy
The professional degree required to practise as a pharmacist in the United States.

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Practice location Address checks out

975 Sereno Dr Mob Medicine 7
Vallejo, CA 94589-2441
Phone: (707) 651-2584
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pharmacist (primary) Taxonomy 183500000X · Licence 51280 (CA)

Record details

NPI number1124110705
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHARMD
Sole proprietorNo
NPI enumeratedSeptember 29, 2006
Last updated in NPPESJuly 8, 2007

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