Active NPI
Bonita Pharmacy
- Pharmacy
- Bonita, CA
National Provider Identifier
1891193470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- PHY 51970
- Legal business name
- BONITA PHARMACY
- Practice address
- 4190 Bonita Rd Ste 101
Bonita, CA 91902-1330 - Phone
- (619) 952-9009
- NPI assigned
- Dec 12, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mohammad Samer Elhomsy, PHARM.D
- Title
- Ceo/Owner
- Phone
- (619) 952-9009
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | PHY 51970 | CA | Primary |
| Community/Retail Pharmacy | 3336C0003X | PHY 51970 | CA |
Addresses
Primary practice location
4190 Bonita Rd Ste 101
Bonita, CA 91902-1330
Mailing address
4190 Bonita Rd Ste 101
Bonita, CA 91902-1330
National Provider Directory
National Provider Directory- Tax ID family
- Bonita Drive Thru Pharmacy
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1418342400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1418342400000",
"number": "1891193470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4190 BONITA RD STE 101",
"city": "BONITA",
"state": "CA",
"postal_code": "919021330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4190 BONITA RD STE 101",
"city": "BONITA",
"state": "CA",
"postal_code": "919021330",
"telephone_number": "619-952-9009"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BONITA PHARMACY",
"organizational_subpart": "NO",
"enumeration_date": "2014-12-12",
"last_updated": "2014-12-12",
"status": "A",
"authorized_official_last_name": "ELHOMSY",
"authorized_official_first_name": "MOHAMMAD",
"authorized_official_middle_name": "SAMER",
"authorized_official_title_or_position": "CEO/OWNER",
"authorized_official_telephone_number": "619-952-9009",
"authorized_official_credential": "PHARM.D"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "CA",
"license": "PHY 51970",
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "CA",
"license": "PHY 51970",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bonita, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.