Healthcare Provider Details
I. General information
NPI: 1033273495
Provider Name (Legal Business Name): NAGLAT ZAKY SEWILAM PHARMACIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10231A TOPANGA CANYON BLVD
CHATSWORTH CA
91311-2804
US
IV. Provider business mailing address
5603 SEA VIEW DR
MALIBU CA
90265-3746
US
V. Phone/Fax
- Phone: 818-772-7475
- Fax: 818-772-8163
- Phone: 310-589-2571
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | RPH 47112 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: