Individual provider Active NPI

Ragy S Gergis

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Corona, CA
National Provider Identifier
1164708657
Registry record updated Oct 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
59000 Issued in CA
Practice address
120 W Parkridge Ave
Corona, CA 92880-1450
Phone
(951) 278-1852
NPI assigned
Oct 27, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2011

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Pharmacist 1835G0303X 59000 CA
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 59000 CA Primary
Pharmacotherapy Pharmacist 1835P1200X 59000 CA
Psychiatric Pharmacist 1835P1300X 59000 CA

Addresses

Primary practice location

120 W Parkridge Ave
Corona, CA 92880-1450

Mailing address

664 Avondale Dr
Corona, CA 92879-8556
Phone (909) 395-7528

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
59000CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1319673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319673600000",
    "number": "1164708657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "664 AVONDALE DR",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928798556",
            "telephone_number": "909-395-7528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W PARKRIDGE AVE",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928801450",
            "telephone_number": "951-278-1852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERGIS",
        "first_name": "RAGY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-27",
        "last_updated": "2011-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835G0303X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Geriatric",
            "state": "CA",
            "license": "59000",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "CA",
            "license": "59000",
            "primary": true
        },
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "CA",
            "license": "59000",
            "primary": false
        },
        {
            "code": "1835P1300X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Psychiatric",
            "state": "CA",
            "license": "59000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2011; 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.