Active NPI
Emad Ibrahim
- Pharmacist
- Marina, CA
National Provider Identifier
1588199756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 68621
- Practice address
- 268 Reservation Rd
Marina, CA 93933-3178 - Phone
- (831) 384-1605
- Fax
- (831) 384-9662
- NPI assigned
- Apr 26, 2017
- Last updated
- Apr 26, 2017
- 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 | 68621 | CA | Primary |
Addresses
Primary practice location
268 Reservation Rd
Marina, CA 93933-3178
Mailing address
268 Reservation Rd
Marina, CA 93933-3178
Phone (831) 384-1605
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
| License | State | Type | Specialty |
|---|---|---|---|
| 68621 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Longs Drug Stores California LLC | Past | Accepting new patients | |
| Longs Drug Store California LLC | Past | Accepting new patients |
Organizations & group practices 2
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": "1493164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493164800000",
"number": "1588199756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "268 RESERVATION RD",
"city": "MARINA",
"state": "CA",
"postal_code": "939333178",
"telephone_number": "831-384-1605",
"fax_number": "831-384-9662"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "268 RESERVATION RD",
"city": "MARINA",
"state": "CA",
"postal_code": "939333178",
"telephone_number": "831-384-1605",
"fax_number": "831-384-9662"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IBRAHIM",
"first_name": "EMAD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-04-26",
"last_updated": "2017-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "68621",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.