Active NPI
Joseph Naoum Mattar Moukarzel, PHARMD
- Pharmacist
- McKinleyville, CA
National Provider Identifier
1508600412
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 89591
- Practice address
- 1720 Central Ave
McKinleyville, CA 95519-3602 - Phone
- (707) 839-5621
- NPI assigned
- Jun 24, 2024
- Last updated
- Jun 24, 2024
- 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 | 89591 | CA | Primary |
Addresses
Primary practice location
1720 Central Ave
McKinleyville, CA 95519-3602
Mailing address
1720 Central Ave
McKinleyville, CA 95519-3602
Phone (707) 839-5621
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 |
|---|---|---|---|
| 89591 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Garfield Beach CVS, L.L.C. | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719187200000",
"number": "1508600412",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1720 CENTRAL AVE",
"city": "MCKINLEYVILLE",
"state": "CA",
"postal_code": "955193602",
"telephone_number": "707-839-5621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1720 CENTRAL AVE",
"city": "MCKINLEYVILLE",
"state": "CA",
"postal_code": "955193602",
"telephone_number": "707-839-5621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAOUM MATTAR MOUKARZEL",
"first_name": "JOSEPH",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-06-24",
"last_updated": "2024-06-24",
"certification_date": "2024-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "89591",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in McKinleyville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.