Active NPI
Jacquleen A Ibrahim
- Pharmacist
- Torrance, CA
National Provider Identifier
1609325356
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 43904
- Practice address
- 4235 Pacific Coast Hwy
Torrance, CA 90505-5525 - Phone
- (310) 373-6847
- Fax
- (310) 373-6294
- NPI assigned
- Sep 22, 2016
- Sex
- Female
- 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 | 43904 | CA | Primary |
Addresses
Primary practice location
4235 Pacific Coast Hwy
Torrance, CA 90505-5525
Mailing address
4235 Pacific Coast Hwy
Torrance, CA 90505-5525
Phone (310) 373-6847
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 |
|---|---|---|---|
| 43904 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474502400000",
"number": "1609325356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4235 PACIFIC COAST HWY",
"city": "TORRANCE",
"state": "CA",
"postal_code": "905055525",
"telephone_number": "310-373-6847",
"fax_number": "310-373-6294"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4235 PACIFIC COAST HWY",
"city": "TORRANCE",
"state": "CA",
"postal_code": "905055525",
"telephone_number": "310-373-6847",
"fax_number": "310-373-6294"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IBRAHIM",
"first_name": "JACQULEEN",
"middle_name": "A",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-22",
"last_updated": "2016-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "43904",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Torrance, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.