Andrew Mansour, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

82447 Issued in CA

Practice address

580 Moraga Rd
Moraga, CA 94556-2211

Phone

(925) 631-0204

NPI assigned

Aug 11, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

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 and National Provider Directory roles.

• Longs Drug Stores California LLC

  • Pharmacy
  • Moraga, CA
  • NPI 1285677039
  NPD (past)
• Longs Drug Store California LLC

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

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

{
    "created_epoch": "1597104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1316558646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 MORAGA RD",
            "city": "MORAGA",
            "state": "CA",
            "postal_code": "945562211",
            "telephone_number": "925-631-0204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 MORAGA RD",
            "city": "MORAGA",
            "state": "CA",
            "postal_code": "945562211",
            "telephone_number": "925-631-0204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSOUR",
        "first_name": "ANDREW",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-11",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "CA",
            "license": "82447",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "82447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Longs Drug Stores California LLC
• Scott D Lothamer, DDS
• Lunar View Optometry
• Madrone Care Network LLC
• Madrone Care Network, an Advanced Practice Nursing Corp
• Marquis Companies I, Inc
• Yasaman Masoudi
• Brea McQuoid
• Moraga Physical Therapy PC
• Moraga Retreat Care Home Incorporated

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.