Individual provider Active NPI

Farah Ryiadh Kormangy

  • Pharmacist
  • San Diego, CA
National Provider Identifier
1235611906
Registry record updated Aug 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
74338 Issued in CA
Practice address
3950 W Point Loma Blvd
San Diego, CA 92110-5601
Phone
(619) 523-1440
Fax
(619) 223-5343
NPI assigned
Aug 30, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 74338 CA Primary

Addresses

Primary practice location

3950 W Point Loma Blvd
San Diego, CA 92110-5601

Mailing address

3950 W Point Loma Blvd
San Diego, CA 92110-5601
Phone (619) 523-1440

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
74338CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1535587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535587200000",
    "number": "1235611906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 W POINT LOMA BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921105601",
            "telephone_number": "619-523-1440",
            "fax_number": "619-223-5343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 W POINT LOMA BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921105601",
            "telephone_number": "619-523-1440",
            "fax_number": "619-223-5343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORMANGY",
        "first_name": "FARAH",
        "middle_name": "RYIADH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-30",
        "last_updated": "2018-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "74338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2018; 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.