Healthcare Provider Details

I. General information

NPI: 1467040915
Provider Name (Legal Business Name): MOSTAFA N ALQEMARY PHARMACIST
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2021
Last Update Date: 05/18/2025
Certification Date: 05/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 N ANAHEIM BLVD STE 445
ANAHEIM CA
92801-1202
US

IV. Provider business mailing address

7361 MIRAMONTE
IRVINE CA
92618-4840
US

V. Phone/Fax

Practice location:
  • Phone: 323-659-0540
  • Fax:
Mailing address:
  • Phone: 714-588-6138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number82382
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number82382
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number82382
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: