Active NPI
Joud Nameh
- Pharmacist
- Eagle Rock, CA
National Provider Identifier
1669124368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 84306
- Practice address
- 1030 Colorado Blvd
Eagle Rock, CA 90041-2502 - Phone
- (323) 255-5130
- NPI assigned
- Jan 24, 2022
- Last updated
- Feb 1, 2022
- 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 | 84306 | CA | Primary |
Addresses
Primary practice location
1030 Colorado Blvd
Eagle Rock, CA 90041-2502
Mailing address
1030 Colorado Blvd
Eagle Rock, CA 90041-2502
Phone (626) 524-0121
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 |
|---|---|---|---|
| 84306 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643673600000",
"number": "1669124368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1030 COLORADO BLVD",
"city": "EAGLE ROCK",
"state": "CA",
"postal_code": "900412502",
"telephone_number": "626-524-0121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1030 COLORADO BLVD",
"city": "EAGLE ROCK",
"state": "CA",
"postal_code": "900412502",
"telephone_number": "323-255-5130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAMEH",
"first_name": "JOUD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-01-24",
"last_updated": "2022-02-01",
"certification_date": "2022-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "84306",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eagle Rock, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.