Individual provider Active NPI

Samer Malak Beskhayroun, RPH

  • Pharmacist
  • Riverside, CA
National Provider Identifier
1104411834
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
82708 Issued in CA
Practice address
9194 Magnolia Ave
Riverside, CA 92503-3872
Phone
(951) 977-8617
NPI assigned
Mar 4, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 82708 CA Primary

Addresses

Primary practice location

9194 Magnolia Ave
Riverside, CA 92503-3872

Mailing address

1850 S Diamond Bar Blvd Apt 601
Diamond Bar, CA 91765-2921
Phone (909) 979-4075

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
82708CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Luxor Pharmacy Corp Current Accepting new patients

Organizations & group practices 1

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": "1614816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1104411834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 S DIAMOND BAR BLVD APT 601",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917652921",
            "telephone_number": "909-979-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9194 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033872",
            "telephone_number": "951-977-8617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BESKHAYROUN",
        "first_name": "SAMER",
        "middle_name": "MALAK",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-04",
        "last_updated": "2021-03-04",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "82708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; 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.