Active NPI
Benish Azhar
- Pharmacist
- Fountain Valley, CA
National Provider Identifier
1063933182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 76409
- Practice address
- 17136 Magnolia St
Fountain Valley, CA 92708-3348 - Phone
- (714) 847-6054
- NPI assigned
- Jun 28, 2017
- Last updated
- Jun 28, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 76409 | CA | Primary |
Addresses
Primary practice location
17136 Magnolia St
Fountain Valley, CA 92708-3348
Mailing address
3 Seacountry LN
Rancho Santa Margarita, CA 92688-5535
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 76409 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Garfield Beach CVS LLC | Past | Accepting new patients | |
| Garfield Beach CVS, L.L.C. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1498608000000",
"number": "1063933182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 SEACOUNTRY LN",
"city": "RANCHO SANTA MARGARITA",
"state": "CA",
"postal_code": "926885535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17136 MAGNOLIA ST",
"city": "FOUNTAIN VALLEY",
"state": "CA",
"postal_code": "927083348",
"telephone_number": "714-847-6054"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AZHAR",
"first_name": "BENISH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-28",
"last_updated": "2017-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "76409",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fountain Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.