OrganizationActive
Innovative Rx Inc
NPI 1063524056 · Compounding Pharmacy · Costa Mesa, CA
Provider details
- NPI number
- 1063524056
- Entity type
- Organization
- Primary specialty
- Compounding PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Mayank Shan, President(949) 642-0106
- License
- PHY48847 (CA)
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
275 Victoria St
Ste 1f
Costa Mesa, CA 92627-1906
Phone: (949) 642-0106
Fax: (949) 642-5039
Street-level locationGet directions
Mailing address
275 Victoria St
Costa Mesa, CA 92627-1906
Other names (DBA / former)
- Doing business as
- Costa Mesa Compounding Pharmacy
Registry dates
- Enumerated
- 2006-08-31
- Last updated
- 2009-10-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.