Individual provider Active NPI

Gehan JM Potrous, RPH

  • Pharmacist
  • Huntington Beach, CA
National Provider Identifier
1700189800
Registry record updated Dec 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH62164 Issued in CA
Practice address
7761 Liberty Dr
#C
Huntington Beach, CA 92647-7704
Phone
(626) 392-0401
NPI assigned
Dec 10, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH62164 CA Primary

Addresses

Primary practice location

7761 Liberty Dr
#C
Huntington Beach, CA 92647-7704

Mailing address

7761 Liberty Dr
#C
Huntington Beach, CA 92647-7704
Phone (626) 392-0401

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
RPH62164CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1291939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291939200000",
    "number": "1700189800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7761 LIBERTY DR",
            "address_2": "#C",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926477704",
            "telephone_number": "626-392-0401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7761 LIBERTY DR",
            "address_2": "#C",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926477704",
            "telephone_number": "626-392-0401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTROUS",
        "first_name": "GEHAN",
        "middle_name": "JM",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-10",
        "last_updated": "2010-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH62164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.

Verify at the official NPI Registry.