Active NPI
Mary Nashat Boctor, PHARMACIST
- Pharmacist
- Moreno Valley, CA
National Provider Identifier
1669793576
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 56186
- Practice address
- 26520 Cactus Ave
Moreno Valley, CA 92555-3927 - Phone
- (951) 486-4613
- NPI assigned
- Jun 15, 2010
- Sex
- Female
- Sole proprietor
- No
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 | 56186 | CA | Primary |
Addresses
Primary practice location
26520 Cactus Ave
Moreno Valley, CA 92555-3927
Mailing address
95 Orangewood CT
Redlands, CA 92373-1446
Phone (909) 792-5386
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 |
|---|---|---|---|
| 56186 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276560000000",
"number": "1669793576",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "95 ORANGEWOOD CT",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923731446",
"telephone_number": "909-792-5386"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26520 CACTUS AVE",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925553927",
"telephone_number": "951-486-4613"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOCTOR",
"first_name": "MARY",
"middle_name": "NASHAT",
"credential": "PHARMACIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-15",
"last_updated": "2010-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "56186",
"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 Jun 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.