Adam Hicham Derkouch, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

74579 Issued in CA

Practice address

5239 E Huntington Ave Apt 202
Fresno, CA 93727-4020

Phone

(917) 547-0767

NPI assigned

Aug 27, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Walgreen Co

  • Pharmacy
  • Fresno, CA
  • NPI 1043389018
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1649751652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6885 N WILLOW AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937105949",
            "telephone_number": "559-322-0698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5239 E HUNTINGTON AVE APT 202",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937274020",
            "telephone_number": "917-547-0767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERKOUCH",
        "first_name": "ADAM",
        "middle_name": "HICHAM",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-27",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "74579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tu Quynh Depry, DO
• Juan Alfredo Deras Espinoza, MD
• Ani Hagop Derboghossian, PHARMD
• Haig Derboghossian
• Jason Derhovanesian, DO
• Wilfred Derksen, MD
• Pamela L Deroian, PHD
• Mark Derr
• Derric Brown LCSW, Licensed Clinical Social Worker Inc.
• Alessandra Gose Desabelle, DDS

• Pharmacist in Fresno, CA
• Providers in Fresno, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2018; 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.