Individual provider Active NPI

Samih Nabil Botros, RPH

  • Pharmacist
  • Mission Viejo, CA
National Provider Identifier
1790908762
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
48680 Issued in CA
Practice address
26732 Crown Valley Pkwy Ste 101
Mission Viejo, CA 92691-8531
Phone
(949) 364-1200
Fax
(949) 364-7240
NPI assigned
Apr 10, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 48680 CA Primary

Addresses

Primary practice location

26732 Crown Valley Pkwy Ste 101
Mission Viejo, CA 92691-8531

Mailing address

26732 Crown Valley Pkwy Ste 101
Mission Viejo, CA 92691-8531
Phone (949) 364-1200

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
48680CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Botrosons Pharmaceutical Inc Current Accepting new patients
Botrosons Pharmaceutical Inc Current Accepting new patients

Locations

26732 Crown Valley Pkwy
Ste 101
Mission Viejo, CA 92691
Phone (949) 364-1200

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790908762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26732 CROWN VALLEY PKWY STE 101",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926918531",
            "telephone_number": "949-364-1200",
            "fax_number": "949-364-7240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26732 CROWN VALLEY PKWY STE 101",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926918531",
            "telephone_number": "949-364-1200",
            "fax_number": "949-364-7240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTROS",
        "first_name": "SAMIH",
        "middle_name": "NABIL",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "48680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.