Individual provider Active NPI

Sarah Sallam, RPH

  • Pharmacist
  • Moreno Valley, CA
National Provider Identifier
1659862563
Registry record updated May 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH63918 Issued in CA
Practice address
12721 Moreno Beach Dr
Moreno Valley, CA 92555-4411
Phone
(951) 242-6599
NPI assigned
May 25, 2018
Last updated
May 25, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH63918 CA Primary

Addresses

Primary practice location

12721 Moreno Beach Dr
Moreno Valley, CA 92555-4411

Mailing address

26468 Sand Palm CT
Moreno Valley, CA 92555-2368

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
RPH63918CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1527206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527206400000",
    "number": "1659862563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26468 SAND PALM CT",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925552368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12721 MORENO BEACH DR",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925554411",
            "telephone_number": "951-242-6599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALLAM",
        "first_name": "SARAH",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-25",
        "last_updated": "2018-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH63918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 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.