Individual provider Active NPI

Michael Abraham Gebru, PHARM D.

  • Pharmacist
  • Oakland, CA
National Provider Identifier
1235384132
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
60380 Issued in CA
Practice address
2447 Telegraph Ave
Oakland, CA 94612-2404
Phone
(510) 984-1429
Fax
(510) 646-9840
NPI assigned
Nov 20, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 60380 CA Primary

Addresses

Primary practice location

2447 Telegraph Ave
Oakland, CA 94612-2404

Mailing address

5460 San Martin Way
Antioch, CA 94531-8506
Phone (213) 840-2931

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
60380CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Selam Pharmacy LLC Current Accepting new patients

Locations

2447 Telegraph Ave
Oakland, CA 94612
Phone (510) 832-7500

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": "1227139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1235384132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5460 SAN MARTIN WAY",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945318506",
            "telephone_number": "213-840-2931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2447 TELEGRAPH AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946122404",
            "telephone_number": "510-984-1429",
            "fax_number": "510-646-9840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEBRU",
        "first_name": "MICHAEL",
        "middle_name": "ABRAHAM",
        "credential": "PHARM D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-20",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "60380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.