Healthcare Provider Details

I. General information

NPI: 1902353287
Provider Name (Legal Business Name): MR. AHMAD ALMULLA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2016
Last Update Date: 03/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2148 BLUEROCK CIR
CONCORD CA
94521-1670
US

IV. Provider business mailing address

901 NEVIN AVE
RICHMOND CA
94801-3143
US

V. Phone/Fax

Practice location:
  • Phone: 925-951-3155
  • Fax: 510-307-1947
Mailing address:
  • Phone: 510-307-3188
  • Fax: 510-307-1947

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number70180
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number70180
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: