Active NPI
Yaser Khoshal
- Pharmacist
- Santa Rosa, CA
National Provider Identifier
1366086241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 80835
- Practice address
- 401 Bicentennial Way
Santa Rosa, CA 95403-2149 - Phone
- (707) 393-4340
- NPI assigned
- Nov 4, 2019
- Sex
- Male
- 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 | 80835 | CA | Primary |
Addresses
Primary practice location
401 Bicentennial Way
Santa Rosa, CA 95403-2149
Mailing address
2615 Spring Oaks Dr
Santa Rosa, CA 95405-9137
Phone (858) 610-0652
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 |
|---|---|---|---|
| 80835 | CA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572825600000",
"number": "1366086241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2615 SPRING OAKS DR",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954059137",
"telephone_number": "858-610-0652"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 BICENTENNIAL WAY",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954032149",
"telephone_number": "707-393-4340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHOSHAL",
"first_name": "YASER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-11-04",
"last_updated": "2019-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "80835",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.