Maie Gamal Fathalla Khalaf, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

80553 Issued in CA

Practice address

760 Washburn Ave Ste 1
Corona, CA 92882-3303

Phone

(951) 707-4500

Fax

(951) 707-4499

NPI assigned

Jul 24, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1595548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595548800000",
    "number": "1295344364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40125 LOS ALAMOS RD APT F157",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925625843",
            "telephone_number": "951-404-8388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 WASHBURN AVE STE 1",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928823303",
            "telephone_number": "951-707-4500",
            "fax_number": "951-707-4499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALAF",
        "first_name": "MAIE",
        "middle_name": "GAMAL FATHALLA",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-24",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "80553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Corona, CA
• Providers in Corona, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2020; 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.