Bassam Kallo, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

82843 Issued in CA

Practice address

12100 Ventura Blvd
Studio City, CA 91604-2514

Phone

(818) 763-5562

Fax

(818) 763-5767

NPI assigned

Aug 27, 2020

Sex

Male

Sole proprietor

No

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

Doctor of Pharmacy

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
  • Studio City, CA
  • NPI 1619919495
  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": "1598486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1386257525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12100 VENTURA BLVD",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916042514",
            "telephone_number": "818-763-5562",
            "fax_number": "818-763-5767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12100 VENTURA BLVD",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916042514",
            "telephone_number": "818-763-5562",
            "fax_number": "818-763-5767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLO",
        "first_name": "BASSAM",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-27",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "82843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joel Warsh MD, Professional Corporation
• Thomas Earl Jones III
• Hyojeong Joo, DDS
• Jose-Luis Ruiz D.D.S., a.P.C.
• Joseph R Shapiro MD, Inc.
• Katelyn Story Kalstein, ND, LAC
• Ofuche Kalu, DC
• Sandeep Kapoor, M.D.
• Karakozian and Kotchounian Dental Corp
• Kare Foods Inc

• Pharmacist in Studio City, CA
• Providers in Studio City, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.