MRS. SHERIH MOUSSA IBRAHIM RPH
Complete NPI Record 1750761771
Pharmacist in Redondo Beach, CA

NPI Status: Active since June 04, 2015

Contact Information

417 SUSANA AVE
REDONDO BEACH, CA
ZIP 90277
Phone: (310) 528-5776

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Complete NPI Dataset

This page represents the complete record for NPI 1750761771. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1750761771
The name of the organization provider. If the provider is an organization, this is the legal business name.
Entity Type Code: 1
Other name by which the organization provider is or has been known.
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Provider First Name: SHERIH
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Middle Name: MOUSSA
The city name in the mailing address of the provider being identified.
Provider Name Prefix Text: MRS.
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Credential Text: RPH
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider First Line Business Mailing Address: 417 SUSANA AVE
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address City Name: REDONDO BEACH
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address State Name: CA
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider Business Mailing Address Postal Code: 902773951
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Mailing Address Country Code If outside U S : US
The city name in the location address of the provider being identified.
Provider Business Mailing Address Telephone Number: 3105285776
The State code in the location of the provider being identified.
Provider First Line Business Practice Location Address: 417 SUSANA AVE
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address City Name: REDONDO BEACH
The country code in the location address of the provider being identified.
Provider Business Practice Location Address State Name: CA
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Postal Code: 902773951
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 3105285776
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date: 6/4/2015
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 6/4/2015
The date that a record was last updated or changed.
Provider Gender Code: F
The code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 183500000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: 52845
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1: CA
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: Y
Is Sole Proprietor: N
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No