NPIMap

Individual provider Active NPI

Mina Megallaa, PHARMD

  • Pharmacist
  • Marina, CA
National Provider Identifier
1740746569
Registry record updated Feb 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
76424 Issued in CA
Practice address
268 Reservation Rd
Marina, CA 93933-3178
Phone
(831) 384-1605
Fax
(831) 384-9662
NPI assigned
Feb 17, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 76424 CA Primary

Addresses

Primary practice location

268 Reservation Rd
Marina, CA 93933-3178

Mailing address

268 Reservation Rd
Marina, CA 93933-3178
Phone (831) 384-1605

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
76424CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Alpha Pharma Inc Current Accepting new patients
Alpha Pharma Inc Current Accepting new patients
Longs Drug Store California LLC Past Accepting new patients
Longs Drug Stores California LLC Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1550361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550361600000",
    "number": "1740746569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "268 RESERVATION RD",
            "city": "MARINA",
            "state": "CA",
            "postal_code": "939333178",
            "telephone_number": "831-384-1605",
            "fax_number": "831-384-9662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "268 RESERVATION RD",
            "city": "MARINA",
            "state": "CA",
            "postal_code": "939333178",
            "telephone_number": "831-384-1605",
            "fax_number": "831-384-9662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEGALLAA",
        "first_name": "MINA",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-17",
        "last_updated": "2019-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "76424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2019; 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.