Active NPI
Ousama Al-Agha, PHARM D
- Pharmacist
- San Diego, CA
National Provider Identifier
1265783377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 45210
- Practice address
- 11350 Trillium Way
San Diego, CA 92131-2935 - Phone
- (858) 271-8855
- NPI assigned
- Sep 28, 2012
- Last updated
- Sep 28, 2012
- Sex
- Male
- Sole proprietor
- Yes
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 | 45210 | CA | Primary |
Addresses
Primary practice location
11350 Trillium Way
San Diego, CA 92131-2935
Mailing address
11350 Trillium Way
San Diego, CA 92131-2935
Phone (858) 271-8855
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1410 | Medicaid | CA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 45210 | CA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348790400000",
"number": "1265783377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11350 TRILLIUM WAY",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921312935",
"telephone_number": "858-271-8855"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11350 TRILLIUM WAY",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921312935",
"telephone_number": "858-271-8855"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AL-AGHA",
"first_name": "OUSAMA",
"name_prefix": "Mr.",
"credential": "PHARM D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-09-28",
"last_updated": "2012-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "45210",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1410",
"state": "CA"
}
],
"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 Sep 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.