Javad Ahmadi, PHARMD
Individual provider Active NPI Pharmacist · Marina, CA
NPI 1336595461 · NPPES record last updated May 7, 2016
Key facts
- NPI
- 1336595461
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 74307 (CA)
- Practice address
- 226 Reservation Rd
Marina, CA 93933-3083 - Phone
- (831) 384-4700
- NPI assigned
- May 7, 2016
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 74307 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 74307 | CA | Yes |
Addresses
Primary practice location
226 Reservation Rd
Marina, CA 93933-3083
Mailing address
226 Reservation Rd
Marina, CA 93933-3083
Phone (831) 384-4700
Other providers in Marina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 7, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.