Individual provider Active NPI

Matthews Eghballi, PHARMD

  • Pharmacist
  • Los Angeles, CA
National Provider Identifier
1770095036
Registry record updated Oct 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
77520 Issued in CA
Practice address
8900 Sepulveda Westway
Los Angeles, CA 90045-3619
Phone
(310) 258-0265
NPI assigned
Oct 26, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 77520 CA Primary

Addresses

Primary practice location

8900 Sepulveda Westway
Los Angeles, CA 90045-3619

Mailing address

310 S Sherbourne Dr Apt 110
Los Angeles, CA 90048-3330
Phone (469) 279-5227

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
77520CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
B7 Health Current Accepting new patients

Organizations & group practices 1

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": "1508976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508976000000",
    "number": "1770095036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 S SHERBOURNE DR APT 110",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900483330",
            "telephone_number": "469-279-5227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 SEPULVEDA WESTWAY",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453619",
            "telephone_number": "310-258-0265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGHBALLI",
        "first_name": "MATTHEWS",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-26",
        "last_updated": "2017-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "77520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2017; 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.