Healthcare Provider Details

I. General information

NPI: 1255279709
Provider Name (Legal Business Name): NOORA KHALAF
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11657 AVENIDA ANACAPA
EL CAJON CA
92019-5007
US

IV. Provider business mailing address

11657 AVENIDA ANACAPA
EL CAJON CA
92019-5007
US

V. Phone/Fax

Practice location:
  • Phone: 619-387-6144
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number92094
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: