Active NPI
Ashak Fakous Botros, PHARM.D
- Pharmacist
- Colusa, CA
National Provider Identifier
1376808576
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 67020
- Practice address
- 1021 Bridge St
Colusa, CA 95932-2839 - Phone
- (530) 458-2494
- Fax
- (858) 412-4306
- NPI assigned
- Jul 12, 2012
- Last updated
- Jul 13, 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 | 67020 | CA | Primary |
Addresses
Primary practice location
1021 Bridge St
Colusa, CA 95932-2839
Mailing address
9245 Regents Rd Unit M107
La Jolla, CA 92037-9264
Phone (818) 919-9723
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 |
|---|---|---|---|
| 67020 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thrifty Payless Inc | Past | Accepting new patients | |
| Thrifty Payless Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Rite Aid Pharmacy 06833
- Community/Retail Pharmacy
- Winchester, CA
- NPI 1437874062
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342137600000",
"number": "1376808576",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9245 REGENTS RD UNIT M107",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "920379264",
"telephone_number": "818-919-9723",
"fax_number": "858-412-4306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1021 BRIDGE ST",
"city": "COLUSA",
"state": "CA",
"postal_code": "959322839",
"telephone_number": "530-458-2494",
"fax_number": "858-412-4306"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOTROS",
"first_name": "ASHAK",
"middle_name": "FAKOUS",
"name_prefix": "Mr.",
"credential": "PHARM.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-07-12",
"last_updated": "2012-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "67020",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colusa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.