Individual provider Active NPI

Sadie Karimi Moshtaghi, PHARMACY TECHNICIAN

  • Pharmacy Technician
  • San Diego, CA
National Provider Identifier
1417242686
Registry record updated Jun 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacy TechnicianTaxonomy code 183700000X
License
75703 Issued in CA
Practice address
5923 Balboa Ave
San Diego, CA 92111-2711
Phone
(619) 813-0458
NPI assigned
Jun 15, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X 75703 CA Primary

Addresses

Primary practice location

5923 Balboa Ave
San Diego, CA 92111-2711

Mailing address

PO Box 81735
San Diego, CA 92138-1735
Phone (619) 813-0458

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

LicenseStateTypeSpecialty
75703CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1308096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308096000000",
    "number": "1417242686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 81735",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921381735",
            "telephone_number": "619-813-0458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5923 BALBOA AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921112711",
            "telephone_number": "619-813-0458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSHTAGHI",
        "first_name": "SADIE",
        "middle_name": "KARIMI",
        "name_prefix": "Mrs.",
        "credential": "PHARMACY TECHNICIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-15",
        "last_updated": "2011-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "CA",
            "license": "75703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2011; 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.