Active NPI
Moheb Kaldas, RPH
- Pharmacist
- Rancho Cucamonga, CA
National Provider Identifier
1124579412
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 66703
- Practice address
- 10374 Trademark St
Rancho Cucamonga, CA 91730-5824 - Phone
- (909) 477-6300
- Fax
- (909) 477-3009
- NPI assigned
- Oct 20, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 | 66703 | CA | Primary |
Addresses
Primary practice location
10374 Trademark St
Rancho Cucamonga, CA 91730-5824
Mailing address
10374 Trademark St
Rancho Cucamonga, CA 91730-5824
Phone (909) 477-6300
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
| License | State | Type | Specialty |
|---|---|---|---|
| 66703 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mari-Mina Pharmaceuticals Inc | Past | 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.
-
- Long Term Care Pharmacy
- Rancho Cucamonga, CA
- NPI 1730439779
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476921600000",
"number": "1124579412",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10374 TRADEMARK ST",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917305824",
"telephone_number": "909-477-6300",
"fax_number": "909-477-3009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10374 TRADEMARK ST",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917305824",
"telephone_number": "909-477-6300",
"fax_number": "909-477-3009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KALDAS",
"first_name": "MOHEB",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-10-20",
"last_updated": "2016-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "66703",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rancho Cucamonga, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.