Frederick Blabagno Samra, PHARMD

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

81761 Issued in CA

Practice address

79795 Highway 111
La Quinta, CA 92253-4756

Phone

(760) 775-0363

NPI assigned

Oct 29, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Nevada CVS Pharmacy LLC

  • Pharmacy
  • Las Vegas, NV
  • NPI 1528581865
  NPD (past)
• Nevada CVS Pharmacy LLC

  • Pharmacy
  • N Las Vegas, NV
  • NPI 1811166283
  NPD (past)
• Warm Springs Road CVS LLC

  • Community/Retail Pharmacy
  • North Las Vegas, NV
  • NPI 1487754826
  NPD (past)
• Warm Springs Road CVS LLC

  • Community/Retail Pharmacy
  • Henderson, NV
  • NPI 1841212545
  NPD (past)

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

{
    "created_epoch": "1572307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1831733294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79795 HIGHWAY 111",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922534756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79795 HIGHWAY 111",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922534756",
            "telephone_number": "760-775-0363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMRA",
        "first_name": "FREDERICK",
        "middle_name": "BLABAGNO",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-29",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "PHA.0022894",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NV",
            "license": "20239",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "81761",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "CA",
            "license": "81761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sahawneh Dental Corporation
• Montserrat Salas Flores
• Cristal Salcido Najar, ND, APCC
• Carolina Saldana
• Savannah L Salwey
• Samuel Ibrahim, MD, Inc
• Gabriel J Sanchez
• Marisa Chaidez Sanchez, NP
• Sanjay Verma, MD a Professional Corporation
• Yvonne Santana

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in La Quinta, CA
• Providers in La Quinta, CA by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; 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.