Healthcare Provider Details

I. General information

NPI: 1831024025
Provider Name (Legal Business Name): SAINT RAFAEL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 E GLADSTONE ST
AZUSA CA
91702-4929
US

IV. Provider business mailing address

475 E GLADSTONE ST
AZUSA CA
91702-4929
US

V. Phone/Fax

Practice location:
  • Phone: 626-621-0010
  • Fax:
Mailing address:
  • Phone: 626-213-0010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MAGED GHALY
Title or Position: CEO/CFO/SEC./DIR.
Credential:
Phone: 310-339-5379