Healthcare Provider Details

I. General information

NPI: 1043016173
Provider Name (Legal Business Name): AVEEN A TAHIR PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AVEEN AHMAD SHARIF

II. Dates (important events)

Enumeration Date: 02/20/2025
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 N 2ND ST
EL CAJON CA
92021-7243
US

IV. Provider business mailing address

215 N 2ND ST
EL CAJON CA
92021-7243
US

V. Phone/Fax

Practice location:
  • Phone: 619-401-0761
  • Fax:
Mailing address:
  • Phone: 619-401-0761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number90340
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: