Individual provider Active NPI

Reza S Momeni, PHARMACY TECHNICIAN

  • Pharmacy Technician
  • Encino, CA
National Provider Identifier
1073723920
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacy TechnicianTaxonomy code 183700000X
License
59208 Issued in CA
Practice address
5474 Newcastle Ave Apt A210
Encino, CA 91316-2063
Phone
(818) 451-3800
NPI assigned
May 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X 59208 CA Primary

Addresses

Primary practice location

5474 Newcastle Ave Apt A210
Encino, CA 91316-2063

Mailing address

5474 Newcastle Ave Apt A210
Encino, CA 91316-2063
Phone (818) 451-3800

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

LicenseStateTypeSpecialty
59208CAMDPharmacy Technician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073723920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5474 NEWCASTLE AVE APT A210",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913162063",
            "telephone_number": "818-451-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5474 NEWCASTLE AVE APT A210",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913162063",
            "telephone_number": "818-451-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOMENI",
        "first_name": "REZA",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "PHARMACY TECHNICIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "CA",
            "license": "59208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.