Individual provider Active NPI

Imadeddin Karaze, RPH

  • Pharmacist
  • Beaumont, CA
National Provider Identifier
1104269752
Registry record updated Jan 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
70554 Issued in CA
Practice address
835 N Highland Springs Ave #110
Beaumont, CA 92223
Phone
(708) 942-9896
NPI assigned
Apr 14, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 26022305A IN
Pharmacist 183500000X 5302030545 MI
Pharmacist 183500000X 051-296416 IL
Pharmacist 183500000X 70554 CA Primary

Addresses

Primary practice location

835 N Highland Springs Ave #110
Beaumont, CA 92223

Mailing address

PO Box 77281
Corona, CA 92877-0109
Phone (708) 942-9896

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
051-296416ILMDPharmacist
26022305AINMDPharmacist
5302030545MIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Home Care LLC Current Accepting new patients
Your Pharmacy, LLC Current Accepting new patients
Your Pharmacy, LLC Current Accepting new patients

Locations

1680 E Sixth St
Ste A
Beaumont, CA 92223
Phone (951) 845-8252

835 Highland Springs Ave
Ste 110
Beaumont, CA 92223
Phone (951) 845-8252

Organizations & group practices 3

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": "1365897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1104269752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 77281",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928770109",
            "telephone_number": "708-942-9896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 N HIGHLAND SPRINGS AVE #110",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "92223",
            "telephone_number": "708-942-9896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARAZE",
        "first_name": "IMADEDDIN",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-14",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26022305A",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302030545",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051-296416",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "70554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2022; 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.