Individual provider Active NPI

Michael G Faragallah

  • Pharmacist
  • Simi Valley, CA
National Provider Identifier
1447566716
Registry record updated Aug 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH 60785 Issued in CA
Practice address
377 Hill Valley CT
Simi Valley, CA 93065-8214
Phone
(805) 651-0102
NPI assigned
Aug 25, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH 60785 CA Primary

Addresses

Primary practice location

377 Hill Valley CT
Simi Valley, CA 93065-8214

Mailing address

377 Hill Valley CT
Simi Valley, CA 93065-8214
Phone (805) 651-0102

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
RPH 60785CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1282694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282694400000",
    "number": "1447566716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "377 HILL VALLEY CT",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930658214",
            "telephone_number": "805-651-0102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 HILL VALLEY CT",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930658214",
            "telephone_number": "805-651-0102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARAGALLAH",
        "first_name": "MICHAEL",
        "middle_name": "G",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-25",
        "last_updated": "2010-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH 60785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2010; 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.