Mina Ibrahem, PHARMACIST

Primary specialty

PharmacistTaxonomy code 183500000X

License

78468 Issued in CA

Practice address

2116 S Broadway
Santa Maria, CA 93454-7812

Phone

(805) 922-7934

NPI assigned

Dec 16, 2019

Last updated

Dec 16, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Longs Drug Store California LLC

  dba Longs Drugs #10987

  • Pharmacy
  • Kapolei, HI
  • NPI 1700565793
  NPD (past)

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

{
    "created_epoch": "1576454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576454400000",
    "number": "1235777665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2116 S BROADWAY",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934547812",
            "telephone_number": "805-922-7934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2116 S BROADWAY",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934547812",
            "telephone_number": "805-922-7934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHEM",
        "first_name": "MINA",
        "credential": "PHARMACIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-16",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "78468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "SantaMaria",
            "affiliation": "N",
            "endpointDescription": "Pharmacy",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2116 S Broadway",
            "city": "Santa Maria",
            "state": "CA",
            "country_code": "US",
            "postal_code": "934547812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jacquelyn Hyde, M.D.
• Amber Lynn Hyland
• Hypertension Nephrology & Internal Medicine Group Inc
• Alejandro Ibarra, MD
• Rosio Marquez Ibarra
• Romany Ibrahim, PHARMACIST
• Clyde Steven Ikeda, D.D.S.
• David J Ikola, MD
• Harsh Ilapakurthi, DO
• Lauren Iliff

• Pharmacist in Santa Maria, CA
• Providers in Santa Maria, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2019; 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.