Healthcare Provider Details

I. General information

NPI: 1659292555
Provider Name (Legal Business Name): ABDUL KAREEM JAWAD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 BELL VIS
FOOTHILL RANCH CA
92610-1832
US

IV. Provider business mailing address

10 BELL VIS
FOOTHILL RANCH CA
92610-1832
US

V. Phone/Fax

Practice location:
  • Phone: 949-439-3919
  • Fax: 559-725-4138
Mailing address:
  • Phone: 949-439-3919
  • Fax: 559-725-4138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number45101
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: