Active NPI
Shirif Wagieh Mitry, PHARM.D., M.B.A.
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Arcadia, CA
National Provider Identifier
1235411455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 0202205746
- Practice address
- 145 E Duarte Rd Ste D
Arcadia, CA 91006-6691 - Phone
- (626) 317-5052
- Fax
- (626) 317-5091
- NPI assigned
- Sep 13, 2011
- Last updated
- Dec 2, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202205746 | VA | |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 0202205746 | VA | Primary |
Addresses
Primary practice location
145 E Duarte Rd Ste D
Arcadia, CA 91006-6691
Mailing address
145 E Duarte Rd Ste D
Arcadia, CA 91006-6691
Phone (626) 317-5052
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
- Master of Business Administration, Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202205746 | VA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Mitry Group Inc | Current | Accepting new patients | |
| Walgreen Co. | Past | Accepting new patients | |
| Kendric R. Kajikawa, O.D. Inc | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
145 E Duarte Rd
Ste D
Arcadia, CA 91006
Phone (626) 317-5052
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Optometrist
- Arcadia, CA
- NPI 1326210261
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638403200000",
"number": "1235411455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "145 E DUARTE RD STE D",
"city": "ARCADIA",
"state": "CA",
"postal_code": "910066691",
"telephone_number": "626-317-5052",
"fax_number": "626-317-5091"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "145 E DUARTE RD STE D",
"city": "ARCADIA",
"state": "CA",
"postal_code": "910066691",
"telephone_number": "626-317-5052",
"fax_number": "626-317-5091"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITRY",
"first_name": "SHIRIF",
"middle_name": "WAGIEH",
"name_prefix": "Dr.",
"credential": "PHARM.D., M.B.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-09-13",
"last_updated": "2021-12-02",
"certification_date": "2021-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202205746",
"primary": false
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "VA",
"license": "0202205746",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arcadia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.