Blast Pharma Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

BLAST PHARMA INC

Practice address

1721 W Katella Ave Ste J
Anaheim, CA 92804-8100

Phone

(714) 733-7879

Fax

(714) 733-7969

NPI assigned

Aug 26, 2021

Organization subpart

No

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

Authorized official

Name

Mohamed HusseinNPI 1003524182

Title

Ceo

Phone

(714) 733-7978

Specialties & licenses 2

Addresses

Other names 1

• BLAST PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mohamed Hussein

  • Pharmacist
  • Anaheim, CA
  • NPI 1003524182
  NPD Authorized official
• Mona Elsayed

  • Pharmacist
  • Anaheim, CA
  • NPI 1184375644
  NPD (past)

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

{
    "created_epoch": "1629936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717632000000",
    "number": "1972270932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 W KATELLA AVE STE J",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928048100",
            "telephone_number": "714-733-7879",
            "fax_number": "714-733-7969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 W KATELLA AVE STE J",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928048100",
            "telephone_number": "714-733-7879",
            "fax_number": "714-733-7969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLAST PHARMA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-26",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A",
        "authorized_official_last_name": "HUSSEIN",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-733-7978"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BLAST PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BLAST PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Diana Blanco
• Samuel Blanco
• Natalie Bland, NP
• Mosi Jamila Blane
• Richard Hedke Blanks, M.D
• Theodore Blatt, MD
• Michael A Blau, D.C.
• BLC Nohl Ranch, LLC
• Summer Kate Bleich
• Blessed Journey Hospice, LLC.

• Community/Retail Pharmacy in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.