Individual provider Active NPI

Shabnam Eragi, PHARMD

  • Pharmacist
  • Orange, CA
National Provider Identifier
1528106861
Registry record updated Sep 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
58600 Issued in CA
Practice address
1120 W la Veta Ave
Orange, CA 92868-4231
Phone
(714) 246-8724
NPI assigned
Feb 1, 2007
Last updated
Sep 5, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH00065607 WA
Pharmacist 183500000X 58600 CA Primary

Addresses

Primary practice location

1120 W la Veta Ave
Orange, CA 92868-4231

Mailing address

1120 W la Veta Ave
Orange, CA 92868-4231
Phone (714) 246-8724

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

LicenseStateTypeSpecialty
PH00065607WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188950400000",
    "number": "1528106861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 W LA VETA AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684231",
            "telephone_number": "714-246-8724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 W LA VETA AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684231",
            "telephone_number": "714-246-8724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERAGI",
        "first_name": "SHABNAM",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00065607",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "58600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2007; 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.