Individual provider Active NPI

Hany Mansour

  • Pharmacist
  • Visalia, CA
National Provider Identifier
1922416874
Registry record updated May 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
58077 Issued in CA
Practice address
444 NW 3Rd Ave
Visalia, CA 93291-3624
Phone
(559) 636-2305
Fax
(559) 636-2882
NPI assigned
Jul 23, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 58077 CA Primary
Pharmacotherapy Pharmacist 1835P1200X 3153934 CA

Addresses

Primary practice location

444 NW 3Rd Ave
Visalia, CA 93291-3624

Mailing address

1819 E Noble Ave
Visalia, CA 93292-1519
Phone (559) 636-2305

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

LicenseStateTypeSpecialty
58077CAMDPharmacist
3153934CAMDPharmacotherapy Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Visalia Pharmacy Inc CurrentSince May 31, 2020 Accepting new patients
Visalia Pharmacy Inc CurrentSince Oct 8, 2023 Accepting new patients

Locations

444 NW 3rd Ave
Visalia, CA 93291
Phone (559) 636-2305

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1406073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590192000000",
    "number": "1922416874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1819 E NOBLE AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932921519",
            "telephone_number": "559-636-2305",
            "fax_number": "559-636-2882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 NW 3RD AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932913624",
            "telephone_number": "559-636-2305",
            "fax_number": "559-636-2882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSOUR",
        "first_name": "HANY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-23",
        "last_updated": "2020-05-23",
        "certification_date": "2020-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "58077",
            "primary": true
        },
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "CA",
            "license": "3153934",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2020; 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.