Provider Demographics
NPI:1487019469
Name:GERGES, BESHOY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BESHOY
Middle Name:
Last Name:GERGES
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16820 BLACKHAWK ST
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-7301
Mailing Address - Country:US
Mailing Address - Phone:818-975-8004
Mailing Address - Fax:
Practice Address - Street 1:8254 WHITE OAK AVE UNIT 4
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325
Practice Address - Country:US
Practice Address - Phone:818-975-8004
Practice Address - Fax:818-975-8094
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-17
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA73225183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist