Active NPI
Maryan Agamy
- Pharmacist
- Rancho Mirage, CA
National Provider Identifier
1245067016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 89363
- Practice address
- 24 Pebble Beach Dr
Rancho Mirage, CA 92270-1608 - Phone
- (949) 232-7982
- NPI assigned
- Sep 17, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 89363 | CA | Primary |
Addresses
Primary practice location
24 Pebble Beach Dr
Rancho Mirage, CA 92270-1608
Mailing address
24 Pebble Beach Dr
Rancho Mirage, CA 92270-1608
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
| License | State | Type | Specialty |
|---|---|---|---|
| 89363 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1726531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726531200000",
"number": "1245067016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24 PEBBLE BEACH DR",
"city": "RANCHO MIRAGE",
"state": "CA",
"postal_code": "922701608"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 PEBBLE BEACH DR",
"city": "RANCHO MIRAGE",
"state": "CA",
"postal_code": "922701608",
"telephone_number": "949-232-7982"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AGAMY",
"first_name": "MARYAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-17",
"last_updated": "2024-09-17",
"certification_date": "2024-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "89363",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rancho Mirage, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.