Individual provider Active NPI

Sougra Bounacdary, PHRAMD

  • Pharmacist
  • Long Beach, CA
National Provider Identifier
1104132463
Registry record updated Aug 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
57762 Issued in CA
Practice address
211 Cherry Ave
Long Beach, CA 90802-3930
Phone
(562) 951-1360
NPI assigned
Aug 25, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 57762 CA Primary

Addresses

Primary practice location

211 Cherry Ave
Long Beach, CA 90802-3930

Mailing address

1912 N Britton Dr
Long Beach, CA 90815-3233
Phone (562) 394-6990

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
57762CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Thrifty Payless Inc Past Accepting new patients
Thrifty Payless Inc 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1282694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282694400000",
    "number": "1104132463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1912 N BRITTON DR",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908153233",
            "telephone_number": "562-394-6990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 CHERRY AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908023930",
            "telephone_number": "562-951-1360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUNACDARY",
        "first_name": "SOUGRA",
        "name_prefix": "Dr.",
        "credential": "PHRAMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-25",
        "last_updated": "2010-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "57762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2010; 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.