Active NPI
Hussam S Basheer Khattab
- Pharmacist
- El Cajon, CA
National Provider Identifier
1851940076
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 80756
- Practice address
- 12094 Calle de Medio Unit 138
El Cajon, CA 92019-4953 - Phone
- (832) 542-9011
- NPI assigned
- Sep 10, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 80756 | CA | Primary |
Addresses
Primary practice location
12094 Calle de Medio Unit 138
El Cajon, CA 92019-4953
Mailing address
12094 Calle de Medio Unit 138
El Cajon, CA 92019-4953
Phone (832) 542-9011
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 80756 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568073600000",
"number": "1851940076",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12094 CALLE DE MEDIO UNIT 138",
"city": "EL CAJON",
"state": "CA",
"postal_code": "920194953",
"telephone_number": "832-542-9011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12094 CALLE DE MEDIO UNIT 138",
"city": "EL CAJON",
"state": "CA",
"postal_code": "920194953",
"telephone_number": "832-542-9011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHATTAB",
"first_name": "HUSSAM",
"middle_name": "S BASHEER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-09-10",
"last_updated": "2019-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "CA",
"license": "80756",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Cajon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.